Season 3 Case 23

History: Fall. Neck Pain

Season 3 Case 23

Case 23

History: Fall with neck pain. What’s the most important finding?


Answer:

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Well there were 2 major findings on this one, but they are related. The one most people saw was the widened atlanto-dental space. Good job. But the one most people didn’t notice was the location of the dens. A little high? or perhaps inside the cranial vault?

I believe this case was all due to Rheumatoid Arthritis, but in the setting of trauma, CT and even MRI are probably good ideas unless you have prior exams.

Answer: Widened atlantodental space with basilar invagination

Reference: http://radiopaedia.org/articles/basilar-invagination

How about all the X-ray lines used to diagnosis it? http://radiopaedia.org/articles/radiographic-assessment-of-basilar-invagination