title: [Chance fracture missed by convencional CT: Presentation of a clinical course].
abstract: BACKGROUND
  Bending-disruption fractures of the vertebral body are called Chance fracture. In some cases these fractures may not be noticeable with a CT scan.
  
  
  METHODS
  A 9 years-old boy suffered a frontal collision while traveling in the back seat of a car. The child was secured by the safetybelt, without a child car seat or elevator adapted to his height. He had abdominal skin lesions in the physical exploration compatible with a belt mark. Conventional thoraco- abdominal CT scan did not show any vertebral fracture. As the clinical suspicion persisted, lateral plain radiography of the lumbar column was performed showing a Chance fracture in L2, confirmed by MRI.
  
  
  CONCLUSIONS
  Chance fracture is typically seen in children under 12 years less than 135 cm height and with injuries associated with the belt after a traffic accident. This type of fractures may go unnoticed in a conventional CT scan so clinical suspicion must lead us to further work-up. The MRI is the gold standard for the diagnosis. This case remarks the importance of the use of homologated elevated seat devices in older children.
authors.affiliation: Servicio de Cuidados Intensivos Pediátricos, Hospital Infantil Universitario Niño Jesús, Madrid, Spain. eperez221981@hotmail.com
authors.forename: Esther
authors.initials: E
authors.lastname: Pérez Suárez
authors.forename: Fernando
authors.initials: F
authors.lastname: Carceller
authors.forename: Alberto
authors.initials: A
authors.lastname: García Salido
authors.forename: Ana
authors.initials: A
authors.lastname: Serrano
authors.forename: Juan
authors.initials: J
authors.lastname: Casado
mesh_terms: D000063:Accidents, Traffic; D002648:Child; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries*; D008297:Male; D012622:Seat Belts / Q000009:adverse effects*; D016103:Spinal Fractures / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed