PMC3513844_01
Lateral cervical spine X-ray. Lateral plain film obtained on admission revealed some pre-vertebral soft tissue swelling; however, no acute fracture or dislocation was appreciated
SNI-3-126-g001.jpg
PMC3513844_01_SNI-3-126-g001.jpg
F1
Plain films revealed no acute fracture or dislocation [Figure 1].
Computed tomography (CT) of the cervical spine. Axial CT images (a-c) demonstrate absent bone fusion of the anterior midline synchondrosis, as well as the posterior midline portions of the C1 bony ring. The osseous components have well-developed cortical margins, strongly suggesting that this midline discontinuity is not the result of trauma
SNI-3-126-g002.jpg
PMC3513844_01_SNI-3-126-g002.jpg
F2
A computed tomography (CT) scan of his cervical spine demonstrated absent bony fusion of the anterior midline synchondrosis, as well as the midline posterior arch of the C1 bony ring [Figure 2a-c].
Magnetic resonance imaging (MRI) of the cervical spine. Sagittal (a) T2-weighted MRI image showing prominent pre-vertebral hyperintensity and fusiform swelling of the pre-vertebral soft tissues, extending from the level of clivus to inferior aspect of the C5 vertebral body, indicating edema. No ligamentous disruption is identified. Axial (b and c) T2-weighted MRI images at the level of the C1 bony ring demonstrate the edema of the paramedian ventral soft tissues at, above, and below the level of the unfused anterior midline synchondrosis
SNI-3-126-g003.jpg
PMC3513844_01_SNI-3-126-g003.jpg
F3
The patient additionally underwent magnetic resonance imaging (MRI) of the cervical spine that demonstrated prominent edema in the pre-vertebral soft tissues extending from the level of the clivus to the vertebral body of C5 [Figure 3a]. Images at the level of the C1 bony ring demonstrated edema of the paramedian ventral soft tissues at, above, and below the level of the unfused anterior midline synchondrosis [Figure 3b and c].