Odontoid PEG fracture - type II

Case contributed by Dr Jeremy Jones


Cyclist. Collision with an oncoming motor vehicle. Thrown from his bike, complained of neck pain. No other bony injury and no neurological symptoms.

Patient Data

Age: 48
Gender: Male

Step in the posterior vertebral line running along the posterior aspect of the vertebral bodies at C2/3. Evidence of C2 fracture with posterior displacement of the fractured PEG.

On the PEG view, the fracture is visualised at the base of the PEG - a type II fracture.

Annotated image

The posterior portions of the cervical vertebral bodies should line up. There is a big jump between the posterior aspect of the PEG and C3 indicating a PEG fracture.

Case Discussion

Isolated fracture of C2, most clearly demonstrated on the lateral film. The PEG view confirms the fracture and helps to type it.

Cross-sectional imaging was performed (but not uploaded). CT confirmed an isolated type II PEG fracture. Underlying cord oedema was confirmed on the MRI.

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Case information

rID: 5106
Published: 4th Dec 2008
Last edited: 7th Sep 2015
Inclusion in quiz mode: Included

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