Unilateral facet joint fracture dislocation

Case contributed by Ahmed Abdalmoneim Elaktaie
Diagnosis certain

Presentation

Severe neck pain and stiffness following fall down 3 days back

Patient Data

Age: 50 years
Gender: Male

Mild anterior slippage of C4 over C5 (anterolisthesis) with disrupted posterior vertebral and spinolaminar lines. Abnormal alignment of C4/5 facet joint (locked facet joint).

CT images demonstrate left C4/5 facet joint dislocation with fracture of C4 left inferior articular process. This is accompanied by posterior-inferior corner triangle fracture of C4. Small bony fragment noted within left C4/5 neural foramen.

N.B: Calcific focus noted adjacent to anterior-inferior corner of C5, less likely to be fracture (preserved cortex of related vertebra).

Case Discussion

Unilateral facet dislocation is relatively stable injury, however MRI is needed to identify any associated soft tissue injuries.

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