C1 and C2 (peg) fractures

Case contributed by Dr Ian Bickle

Presentation

Presented to ED with neck pain. She is believed to have fallen 'head first' down a flight of stairs.

Patient Data

Age: 85 years
Gender: Female
CT

Fracture through the body of the odontoid peg.

Fracture of right anterior arch of C1.

Bilateral congenital non-union of the posterior arch at accessory lateral synchondroses (the bone margin here is very defined).

Multilevel degenerative change.

Case Discussion

This cervical spine trauma CT has both a peg (C2) and C1 fracture.

However, the C1 component initially was thought to be a Jefferson fracture (we all learn everyday), however, on retrospect is only a unilateral C1 anterior arch fracture.

The linear 'defect' through the posterior arches of the atlas (C1) are smooth and rather established-looking and are in fact thought to represent congenital non-union of the posterior arch lateral synchondroses.

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Case information

rID: 36618
Published: 13th Jul 2015
Last edited: 7th Sep 2019
Tag: rdgh
Inclusion in quiz mode: Included

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