WIDI - CA0985-C5C6 Facet Rotation and Fractures, radiograph

C5C6 Facet Rotation and Fractures, radiograph

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0.5 CME Credit available on completion

POINT OF CARE INFORMATION

This CME activity consists of the student reviewing the video of the professor reviewing the case as well as the associated DICOM image set related to the case in question.

Learning Objectives

As a result of participation in this activity, participants should be able to:

Provide improved patient care.
Greater knowledge of the imaging characteristics of the patient's disease.
Understand a better approach to interpretation of studies.

Faculty Disclosure

Mehmet Albayram, MD, Ivan Davis, MD, Mariam Hanna, MD, Anthony Mancuso, MD, Ronald Quisling, MD, Dhanashree Rajderkar, MD, Priya Sharma, MD, Roberta Slater, MD and Joann Stamm, MBA have disclosed that they have no relevant financial relationships. No one else is a position to control content have any financial relationship to disclose.

CME Advisory Committee Disclosure:

Conflict of interest information for the CME Advisory Committee members can be found on the following website: https://cme.ufl.edu/disclosure/.

Continuing Medical Education Credit

Accreditation: The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit: The University of Florida College of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CA0985-C5C6 Facet Rotation and Fractures, radiograph

History

17 yo male with C-spine injury. Evaluate for ligamentous injury.

Exam

C spine flexion and extension views

Prior Study

Trauma CT scan

Findings

Technique

The cranio-cervical junction is included, but C7 and T1 are underpenetrated.

The flexion and extension views are somewhat limited.

Prevertebral and paravertebral soft tissues

The soft tissues anterior to C5-C6 are prominent especially on the limited extension view, but measure within the normal range.

Spinal alignment

The occipital cervical alignment and the atlanto-axial joint distance are normal.

The anterior vertebral body line, posterior vertebral body line, articular pillar lines, and spinolaminar line are abnormal at C4-C5 and C5-C6. The articular pillars are rotated and displaced into the spinal canal including the interlaminar clear zone at C5-C6.

There is kyphotic angulation but no motion of the cervical spine at C5-C6 on the flexion and extension views.

Vertebral bodies, posterior elements, and base of skull

There are fractures of the facets at C5. There is no displacement of a fracture fragment into the soft tissues, spinal canal, or interlaminar clear zone of the spinal canal. There is no vertebral body fracture.

Disc spaces and facet joints

There is no distraction or focal widening of a disc space, but there is disc space narrowing at C5-C6.

There is grade 1 anterolisthesis of C4 on C5 and grade 2 anterolithesis of C5 on C6.

There is widening and rotational abnormality of the facets at C5-C6 with facet dislocations.

Additional soft tissues and bones (neck, airway, upper thorax, ribs)

The airway is not narrowed or displaced.

There are postsurgical changes of the anterior facial region.

Other findings

There are no degenerative changes or other existing conditions that might be contributing to symptoms.

Impression

There is abnormal angulation of the cervical spine at C5-C6 on the flexion and extension views with grade 1 anterolisthesis of C4 on C5 and grade 2 anterolisthesis of C5 on C6 from ligamentous injury. There is widening and rotational abnormality of the facets at C5-C6 with fractures of the C5 facets.