There is an oblique fracture through the odontoid peg with posterior subluxation of C1 and the fractured peg with respect to the body of C2. The peg is angulated posteriorly with displacement of approximately 6mm at its base. The cranio-cervical canal remains widely patent with ample room for the spinal cord. The posterior elements of C1 are congenitally not fused at least posteriorly and on the left. On the right there is a rather irregular and slightly sclerotic gap between the lamina and lateral mass which may well be a genuine fracture but it is not really displaced. The remainder of the cervical spine shows extensive spondylosis with virtual fusion of the facet joints but no further fracture.