Unilateral facet joint dislocation and fracture

Case contributed by Lee-Anne Slater
Diagnosis certain

Presentation

Fell off a 4m ladder 1 week prior. CT done on the initial presentation to the hospital was normal and he was discharged. A week after the fall, he was brushing his teeth and then heard a crack. The following images were obtained during the 2nd visit.

Patient Data

Age: 60 years
Gender: Male

Cervical Spine x-ray demonstrates anterolisthesis of C4 on C5. This is associated with disruption of the spinolaminar line. The facet joints at this level are also noted to be assymetrical.

There is also incidental congenital fusion of C2 and C3.

CT imaging confirms dislocation of the left facet joint with an associated fracture.

The rotatory effect of the unitlateral dislocation is seen on the axial CT images

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