C1 and C2 (peg) fractures
Presented to ED with neck pain. She is believed to have fallen 'head first' down a flight of stairs.
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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.
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.