Anterior tilt of the odontoid: Is it always a sign of fracture?

Abstract

In adults, anterior tilt of the odontoid is an onfinous finding that implies either a type II (high) or III (low) dens fracture or traumatic spondylolisthesis (hangman's fracture). In pediatric patients, anterior tilt may be associated with injury or, as in this case, may be a normal variation. This finding is not listed in the most frequently referenced atlases of normal radiographic findings. :igure i