Presentation
Motor vehicle accident, car driver.
Patient Data
No evidence of fracture or dislocation in the cervical spine.
The dens, the cervical lordosis, and the bony structure of the cervical vertebrae are preserved.
Limbus vertebra at the anterosuperior corner of C5. Subtle vacuum phenomenon at the anteroinferior aspect of intervertebral discs C4-C5 to C6-C7.
Posterior cervicothoracic hematoma left of the midline, involving several posterior neck muscles and the trapezius muscle, with no evidence of active arterial bleeding (chest-abdomen-pelvis arterial phase scan not shown).
Case Discussion
Car driver whose car got hit by another car coming from the right (passenger side). Airbags inflated. No loss of consciousness. A rigid neck collar was applied on site. CT trauma, total body, was done. The only traumatic finding was a posterior cervicothoracic hematoma.
Incidental C5 limbus vertebra. Although a cervical limbus vertebra is rare, it should not be mistaken for a fracture.
Findings in favor of limbus vertebra vs acute vertebral fracture: limbus vertebra tends to favor the anterosuperior vertebral corner; corticated margins on both sides; no prevertebral hematoma or fat stranding; Schmorl nodes (none in this case). Interestingly, intervertebral disc vacuum phenomenon (seen here) can signify nascent Schmorl nodes.