Perched facet joint

Case contributed by Charudutt Jayant Sambhaji
Diagnosis certain

Anterolisthesis of C5 over C6, and one of the inferior articular facets of C5 is slipped in front and is lying atop of the superior articular facet of C6 (so called perched facet).

Annotated image

Zoomed, and zoomed and annotated images demonstrating the perched facet joint in more detail. 


Sagittal T1 and T2 images demonstrate the location of perched facet with minimal T2 hyperintense synovial fluid posterior to the right superior facet of C6.

The GRE sagittal image shows normal bright signal in the left vertebral artery, while the bright signal in right vertebral artery is lost s/o thrombosis.

The T2 axial image shows loss of signal void in the right vertebral artery suggestive of thrombosis.

Case Discussion

"Perched facet joints" are vertebral facet joint whose inferior articular process appears to sit 'perched' on the ipsilateral superior articular process of the vertebra below. Any further anterior subluxation will result in dislocation, with one facet "jumping" over the other and becoming locked in this position. 

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