WIDI - CA0986-C5C6 Facet Rotation and Perch, radiograph

C5C6 Facet Rotation and Perch, radiograph

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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.

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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.

CA0986-C5C6 Facet Rotation and Perch, radiograph

History

47 yo male; neck pain after trauma

Exam

frontal, lateral, odontoid views

Prior Study

trauma CT

Findings

Technique

The craniocervical junction and C7-T1 are not entirely included on the exam. There are overlying bones and soft tissues and C7-T1 is underpenetrated. The odontoid view is also limited by positioning.

Prevertebral and paravertebral soft tissues

The soft tissues anterior to C5 are widened likely from soft tissue swelling.

Spinal alignment

Limited view of the craniocervical junction is normal. The atlanto-axial joint distance is normal.

The anterior vertebral body line, posterior vertebral body line, articular pillar lines, and spinolaminar line are abnormal. There is anterior subluxation of C5 on C6 and there is rotational abnormality of the articular pillars at C5-C6 with subsequent narrowing of the spinal canal.

The spinous processes at C5-C6 are distracted on the lateral view and rotated on the frontal view.

There is kyphotic angulation at C5-C6.

Vertebral bodies, posterior elements, and base of skull

There is a fracture of the superior facet of C6. There is no displacement of a fracture fragment into the soft tissues, spinal canal or interlaminar clear zone of the spinal canal.

There is slight compression of the anterior superior C6 vertebral body and endplate.

Disc spaces and facet joints

There is grade 2 anterolisthesis with narrowing and rotational abnormality of the C5-C6 disc space.

There is facet widening, rotational abnormality, and displacement of the facets at C5-C6 and likely perched facets at C5-C6.

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

There is a linear density overlying the right maxilla likely from a dental procedure.

There is apical thickening on the left. This can be compared to older exams or followed on subsequent exams.

The airway is not narrowed or displaced.

Other findings

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

Impression

There is grade 2 anterolisthesis at C5-C6 with facet widening, rotational abnormality, and displacement of the facets. There likely are perched facets at C5-C6. There is a fracture of the superior facet of C6.