WIDI - CA0984-C2 Bilateral Pars Hangman's Fracture, radiograph

C2 Bilateral Pars Hangman's Fracture, radiograph

Claim CME Credit

0.5 CME Credit available on completion

POINT OF CARE INFORMATION

This CME activity consists of the student reviewing the video of the professor reviewing the case as well as the associated DICOM image set related to the case in question.

Learning Objectives

As a result of participation in this activity, participants should be able to:

Provide improved patient care.
Greater knowledge of the imaging characteristics of the patient's disease.
Understand a better approach to interpretation of studies.

Faculty Disclosure

Mehmet Albayram, MD, Ivan Davis, MD, Mariam Hanna, MD, Anthony Mancuso, MD, Ronald Quisling, MD, Dhanashree Rajderkar, MD, Priya Sharma, MD, Roberta Slater, MD and Joann Stamm, MBA have disclosed that they have no relevant financial relationships. No one else is a position to control content have any financial relationship to disclose.

CME Advisory Committee Disclosure:

Conflict of interest information for the CME Advisory Committee members can be found on the following website: https://cme.ufl.edu/disclosure/.

Continuing Medical Education Credit

Accreditation: The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit: The University of Florida College of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CA0984-C2 Bilateral Pars Hangman's Fracture, radiograph

History

19 yo female s/p trauma

Exam

frontal, lateral, odontoid views

Prior Study

trauma CT scan

Findings

Technique

The exam is slightly limited by overlying structures and support devices. The odontoid view is limited by patient positioning.

Prevertebral and paravertebral soft tissues

The soft tissues are normal. There is no prevertebral soft tissue swelling.

Spinal alignment

The craniocervical alignment and the atlanto-axial joint distance are normal. The relationship of the dens with the lateral masses of C1 is normal on the odontoid and AP views.

The anterior vertebral body line and posterior vertebral body line are abnormal with slight anterior displacement of C2 on C3. The articular pillar lines and spinolaminar line are abnormal from rotation and slight posterior displacement of the posterior elements of C2 on C3.

There is no significant abnormal curvature of the cervical spine though the patient is in a collar.

Vertebral bodies, posterior elements, and base of skull

There are pars or pedicle fractures of C2 with rotation and distraction of the posterior elements.

There is possibly a small fracture of the posterior superior aspect of the articular pillar of C3 at the facet joint. There is no displacement of a fracture fragment into the soft tissues, spinal canal, or interlaminar clear zone of the spinal canal.

Disc spaces and facet joints

There is no distraction or focal widening of a disc space.

There is slight anterolisthesis of the C2-C3 disc space.

There is slight rotational abnormality of the C2 facets.

Additional soft tissues and bones (neck, airway, upper thorax, ribs)

The included maxillofacial region and upper thorax are normal. There is no apical mass or pneumothorax. The airway is not narrowed or displaced.

Other findings

There are no degenerative changes or other existing conditions that might be contributing to symptoms.

Impression

There are bilateral pars fractures of C2 from a “hangman’s fracture” with mild rotation and distraction of the posterior elements of C2. There is slight anterolisthesis at C2-C3.