Pseudospread of the atlas: false sign of Jefferson fracture in young children.
Jefferson fractures are rare prior to teen-age. Three young children examined after trauma exhibited the characteristic spread appearance of the atlas, but fractures were excluded radiographically and clinically. A retrospective study demonstrated a similar appearance, termed "pseudospread," in most children aged 3 months to 4 years, including over 90% during the second year. Pseudospread results from a discrepancy between the "neural" growth pattern of the atlas and the "somatic" pattern of the axis. An "atlas spread index" is defined and a normal range presented. When an atlas fracture is suggested by apparent lateral spread of the lateral atlas masses, computed tomography is useful to demonstrate an intact atlas ring.
D001368:Axis, Cervical Vertebra / Q000254:growth & development; D001270:Cervical Atlas / Q000000981:diagnostic imaging / Q000254:growth & development / Q000293:injuries*; D002648:Child; D002675:Child, Preschool; D005189:False Positive Reactions; D050723:Fractures, Bone / Q000000981:diagnostic imaging*; D005596:Fractures, Closed / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D014711:Vertebral Artery / Q000000981:diagnostic imaging