title: Second cervical vertebrae pedicle fractures versus synchondrosis in a child.
abstract: Fractures of the second cervical vertebrae (C2) can be difficult to diagnose in young children. A 17-month-old infant sustained bilateral C2 pedicle fractures after minor trauma. The initial lateral radiograph showed pedicle defects, but even with computed tomography and a bone scan with single photon emission computed tomography this could not be differentiated from a congenital abnormality. One week after injury, repeat radiographs showed spondylolisthesis confirming the defects were fractures. The fractures were treated by closed reduction and a halo vest and healed uneventfully. This child is among a small number of patients with bilateral C2 pedicle fractures that occur predominantly in young children. Diagnosis can be difficult even with a high index of suspicion.
authors.affiliation: Pediatric Orthopedics, Rainbow Pediatric Trauma Center, Rainbow Babies and Children's Hospital, 11000 Euclid Avenue, Cleveland, OH 44106, USA.
authors.forename: Nicolas E
authors.initials: NE
authors.lastname: Grisoni
authors.forename: R Tracy
authors.initials: RT
authors.lastname: Ballock
authors.forename: George H
authors.initials: GH
authors.lastname: Thompson
mesh_terms: D002574:Cervical Vertebrae / Q000293:injuries*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D007593:Joint Instability / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011859:Radiography; D011877:Radionuclide Imaging; D016103:Spinal Fractures / Q000175:diagnosis* / Q000000981:diagnostic imaging