Presentation
High-speed motor vehicle collision. Chest and back pain.
Patient Data
There is widening of the anterior intervertebral disc space at C6-7 level with a bony fragment arising from the anterior-inferior endplate of C6.
There are acute, nondisplaced fractures of right lateral fourth through tenth ribs, and of the left anterior fourth and fifth ribs. There is an acute obliquely oriented fracture of the mid and lower sternal body (best appreciated on the coronal plane).
Nonacute osseous findings include moderate multilevel degenerative disc disease, most pronounced at L4-5 and L5-S1 levels with intervertebral disc space narrowing, subchondral cysts, and anterior osteophytes. There is minimal anterolisthesis of L4 on L5 and L5 on S1, related to facet hypertrophic change.
Case Discussion
This is a case of multiple traumatic fractures, including an extension teardrop fracture (fracture of the anteroinferior corner of the vertebral body) with corresponding anterior disc space widening, There is also an obliquely oriented sternal fracture and multiple bilateral rib fractures.
Co-author:
Christine Cooley, MD
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