C4 Teardrop Fracture, C4, C7 Fractures, radiograph
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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.
CA0997-C4 Teardrop Fracture, C4, C7 Fractures, radiograph
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CA0997-C4 Teardrop Fracture, C4, C7 Fractures, radiograph
Case ReportHistory
Exam
Prior Study
Findings
Technique
The craniocervical junction is included on the exam. There is limited evaluation of C7-T1 on the swimmer's view.
Prevertebral and paravertebral soft tissues
The soft tissues anterior to C4-C7 are slightly widened.
Spinal alignment
The craniocervical junction is normal.
The atlanto-axial joint distance is not > 2 mm on the lateral view.
The lateral masses of C1 do not abnormally override the articular pillars of C2 on the odontoid or AP view.
The anterior vertebral body line is abnormal from a fracture of the anterior inferior C4 vertebral body. The articular pillar lines and the spinolaminar line at C6-C7 are abnormal likely from a fracture of the posterior elements of C7.
The articular pillars of C7 are rotated or displaced into the spinal canal including the interlaminar clear zone.
The spinous processes at C4-C5 are mildly distracted on the lateral view. There is slight widening of the spinous processes at C6-C7.
There is straightening of the cervical spine on the lateral view.
Vertebral bodies, posterior elements, and base of skull
There is a fracture of the anterior inferior C4 vertebral body and end plate in a teardrop configuration with anterior inferior displacement of the fracture fragment into the soft tissues. There likely is a fracture of the spinous process of C4 at the spinolaminar line. There is a fracture of the posterior elements of C7 likely with a fragment in the interlaminar clear zone of the spinal canal.
Disc spaces and facet joints
There likely is rotational abnormality of the facets at C6-C7.
Additional soft tissues and bones (neck, airway, upper thorax, ribs)
The included maxillofacial region and the upper thorax are normal.
There is no apical mass or pneumothorax.
The airway is not narrowed or displaced.
Other findings
There is mild degenerative change with anterior osteophytes at C2 and involving the lower cervical spine.
