30 year-old female with history of the C1/2 abnormality. Cervalgia.IMAGE ACQUISITIONS: Non-infused CT of the cervical spine. There is deformity and abnormal rotation at the level of the atlantoaxial joint suggesting subluxation. Additionally, there is irregular lucency within the dens. However, no associated bone marrow signal abnormality was seen on the recent MRI and there is no soft tissue swelling in this region. More likely, the dens finding represents a chronic nonhealing fracture then an acute abnormality. Additional degenerative changes at this level including subchondral cyst formation.
1. Lucency in the dens without associated findings to suggest acute fracture. More likely the findings represent chronic nonhealing fracture.2. Rotational deformity at the atlantoaxial joint suggests subluxation. Flexion and extension radiographs could be considered to assess stability.