Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- Section 1 Brain, head, and neck
- Section 2 Spine
- Case 19 Variants of the upper cervical spine
- Case 20 Atlantoaxial rotatory fixation versus head rotation
- Case 21 Cervical flexion and extension radiographs after blunt trauma
- Case 22 Pseudosubluxation of C2–C3
- Case 23 Calcific tendinitis of the longus colli
- Case 24 Motion artifact simulating spinal fracture
- Case 25 Pars interarticularis defects
- Case 26 Limbus vertebra
- Case 27 Transitional vertebrae
- Case 28 Subtle injuries in ankylotic spine disorders
- Case 29 Spinal dural arteriovenous fistula
- Section 3 Thorax
- Section 4 Cardiovascular
- Section 5 Abdomen
- Section 6 Pelvis
- Section 7 Musculoskeletal
- Section 8 Pediatrics
- Index
- References
Case 28 - Subtle injuries in ankylotic spine disorders
from Section 2 - Spine
Published online by Cambridge University Press: 05 March 2013
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- Section 1 Brain, head, and neck
- Section 2 Spine
- Case 19 Variants of the upper cervical spine
- Case 20 Atlantoaxial rotatory fixation versus head rotation
- Case 21 Cervical flexion and extension radiographs after blunt trauma
- Case 22 Pseudosubluxation of C2–C3
- Case 23 Calcific tendinitis of the longus colli
- Case 24 Motion artifact simulating spinal fracture
- Case 25 Pars interarticularis defects
- Case 26 Limbus vertebra
- Case 27 Transitional vertebrae
- Case 28 Subtle injuries in ankylotic spine disorders
- Case 29 Spinal dural arteriovenous fistula
- Section 3 Thorax
- Section 4 Cardiovascular
- Section 5 Abdomen
- Section 6 Pelvis
- Section 7 Musculoskeletal
- Section 8 Pediatrics
- Index
- References
Summary
Imaging description
Ankylotic spine disorders, including seronegative spondyloarthropathy (especially ankylosing spondylitis) and diffuse idiopathic skeletal hyperostosis (DISH), result in osseous fusion of the vertebral elements which restrict physiologic motion of the vertebral column and predispose the spine to atypical fractures even with minimal trauma.
Radiographs may not delineate the subtle fractures often seen in ankylotic disorders (Figure 28.1). It can also be difficult on radiographs to determine the full extent of the fracture (Figure 28.2), differentiate incomplete ankylosis from fracture, or evaluate the soft tissues. For these reasons, when ankylosis is encountered, the radiologist must have a high level of suspicion for an occult fracture, and CT or MR should be utilized liberally.
Injuries in the setting of ankylosis often involve all three spinal columns [1]. MR is superior for the evaluation of the disk space, soft tissues, and spinal cord. Soft tissue trauma including ligament tears and transdiskal injuries may be diagnosed on CT by subtle widening of the intervertebral space compared to adjacent levels [2]. CT angiography or MR angiography may also be necessary to evaluate for vascular injury if the fracture extends to the foramen transversarium.
- Type
- Chapter
- Information
- Pearls and Pitfalls in Emergency RadiologyVariants and Other Difficult Diagnoses, pp. 95 - 97Publisher: Cambridge University PressPrint publication year: 2013