IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

C1 and C2 (peg) fractures

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Presented to ED with neck pain. She is believed to have fallen 'head first' down a flight of stairs.

Patient Data

Age: 85 years
Gender: Female
ct

Fracture through the body of the odontoid peg.

Fracture of right anterior arch of C1.

Bilateral congenital non-union of the posterior arch at accessory lateral synchondroses (the bone margin here is very defined).

Multilevel degenerative change.

Case Discussion

This cervical spine trauma CT has both a peg (C2) and C1 fracture.

However, the C1 component initially was thought to be a Jefferson fracture (we all learn everyday), however, on retrospect is only a unilateral C1 anterior arch fracture.

The linear 'defect' through the posterior arches of the atlas (C1) are smooth and rather established-looking and are in fact thought to represent congenital non-union of the posterior arch lateral synchondroses.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.