Chalk stick fracture

Case contributed by Dr Bruno Di Muzio

Presentation

Trauma.

Patient Data

Age: 45 years
Gender: Male
CT

CT Cervical Spine

Features in keeping with ankylosing spondylitis are demonstrated and characterized by ossification of the spinal ligaments and fusion of the facet joints. There is a transverse fracture line through the ossified anterior longitudinal ligament at the disc level of C3/4 that extends posteriorly to both the ankylosed facet joints at this level.

MRI

MRI Cervical Spine (trauma)

Features in keeping with ankylosing spondylitis are again demonstrated and characterized by ossification of the spinal ligaments and fusion of the facet joints. There is a transverse fracture line through the ossified anterior longitudinal ligament at the disc level of C3/4 that extends posteriorly to both the ankylosed facet joints at this level (better seen on CT). There is paravertebral soft tissue edema from C2 to C4. Focal marrow edema is noted along the fracture lines through the C3/4 facet joints. Also, posterior paraspinal muscular and interspinous edema from C2 to C5 bilaterally and more prominent on the left. Vertebral height, disc height, bone marrow signal, and alignment are normal. The cord is normal in signal. No evidence of an epidural hematoma. The canal and neural exit foramina are capacious with no high-grade stenosis. Normal flow-voids are demonstrated in the vertebral arteries. Limited views of the posterior fossa are unremarkable.

Cervical spine radiographs

Anterior spinal fusion at C3-4 level is satisfactory.

Case Discussion

This case illustrates a nondisplaced fracture involving the ankylosed spine at the level of C3/4 ("chalk stick fracture"). 

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Case information

rID: 57717
Published: 10th Jan 2018
Last edited: 14th Aug 2019
System: Spine, Trauma
Inclusion in quiz mode: Included

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