Pseudosubluxation of C2/3

Case contributed by Dr Jeremy Jones

Presentation

RTC car vs. bike. Thrown into the air. Neck pain with mid-cervical midline tenderness. No obvious distracting injury.

Patient Data

Age: 5 years
Gender: Male
X-ray

The cervical spine is to C7. Vertebral bodies are normal, as is alignment. No fracture or pre-vertebral soft-tissue swelling.

Case Discussion

This is a normal study in a trauma patient. Two commonly misdiagnosed normal findings are present there:

Pseudosubluxation refers to the apparent anterior displacement of C2 on C3 (and sometimes C3 on C4). This is a normal finding and seen in many patients under the age of 7.

Vertebral body shape has this wedged appearance in the young child with apparent deficiency of the superior endplate. As the child ages, the ring apophysis appears and as they get still older, ossification occurs resulting in the normal rectangular relief on the lateral view.

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Case information

rID: 43445
Case created: 10th Mar 2016
Last edited: 16th Nov 2017
Inclusion in quiz mode: Included

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