RT Journal Article
SR Electronic
T1 Delayed diagnosis of fractured anterior arch of the atlas in a young child
JF BMJ Case Reports
FD BMJ Publishing Group Ltd
SP bcr2016214472
DO 10.1136/bcr-2016-214472
VO 2017
A1 Sergio B Sesia
A1 Friederike Prüfer
A1 Michael Walther
A1 Daniel Studer
YR 2017
UL http://casereports.bmj.com/content/2017/bcr-2016-214472.abstract
AB A 2-year-old girl fell off a bunk bed onto a parquet floor. She immediately reported neck pain and presented with muscle spasm and limited motion of the cervical spine (C-spine). Plain X-rays of the C-spine showed no osseous lesion. Owing to persisting pain and limited motion in the neck, MRI of the C-spine was obtained which revealed intact ligaments and cervical spinal cord, as well as soft tissue swelling in front of the anterior arch of the atlas. Subsequent CT of the C-spine confirmed a complete, undisplaced fracture of the anterior arch of the atlas (Gehweiler type I fracture). A Minerva cast was applied for 2 months, followed by a soft cervical collar. Persistent neck pain and limited range of motion of the neck after a fall may be indicative of atlas fracture that should be ruled out by CT.