Abstract
BackgroundCongenital spinal abnormalities can easily be misdiagnosed on plain radiographs. Additional imaging is warranted in doubtful cases, especially in a setting of acute trauma.Case PresentationThis patient presented at the emergency unit of our university hospital after a motor vehicle accident and was sent to our radiology department for imaging of the cervical spine. Initial clinical examination and plain radiographs of the cervical spine were performed but not conclusive. Additional CT of the neck helped establish the right diagnosis.ConclusionCT as a three-dimensional imaging modality with the possibility of multiplanar reconstructions allows for the exact diagnosis and exclusion of acute traumatic lesions of the cervical spine, especially in cases of doubtful plain radiographs and when congenital spinal abnormalities like absent cervical spine pedicle with associated spina bifida may insinuate severe trauma.
Highlights
Congenital spinal abnormalities can be misdiagnosed on plain radiographs
computed tomography (CT) as a three-dimensional imaging modality with the possibility of multiplanar reconstructions allows for the exact diagnosis and exclusion of acute traumatic lesions of the cervical spine, especially in cases of doubtful plain radiographs and when congenital spinal abnormalities like absent cervical spine pedicle with associated spina bifida may insinuate severe trauma
The patient was discharged from the emergency room without surgical intervention. He was informed and gave informed consent that data concerning his case would be submitted for publication. In this case, congenital Absent cervical spine pedicle (ACSP) of C5 with associated osseous spinal abnormalities in a male patient who has had a motor vehicle accident was misdiagnosed as a cervical fracture on plain radiographs
Summary
The knowledge of rare congenital osseous abnormalities of the spine such as ACSP as well as of their typical radiographic appearance is essential for correct diagnosis. In a setting of acute trauma when radiography is indicated, CT should be considered as primary choice to establish diagnosis and prevent misinterpretation of congenital abnormalities on plain radiographs. Consent Written informed consent was obtained from the patient for publication of this case report and any accompanying images. Author details 1Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland. Authors’ contributions RG performed the literature search and compiled data presented in this report. GA and HS provided the expertise for selective imaging and contributed to the diagnosis. PS provided intellectual input and critically revised the manuscript. All authors read and approved the final manuscript.
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