Widening of the lateral atlanto-axial joints bilaterally, (right greater than left) with increased median atlantoaxial joint distance, and widening of the right atlanto-occipital joint. Blood is present deep to the PLL at the level of the dens and is associated with soft tissue thickening in this region suggestive of ligamentous disruption. Stranding also seen within the C1/2 interspinous space also indicative of ligamentous sprain /disruption.