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The atlantooccipital joints are widened bilaterally, with an increased basion-dens interval to 13mm (normal < 12mm). The prevertebral soft tissues are enlarged due to extensive swelling anterior to C1-4. There is also swelling noted posterior to C1/2 in the interspinous region. No fractures are identified.
Incidentally noted is an ununited posterior arch of C1 (a common normal variant of no clinical significance), not to be confused with a fracture.