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Radiographs including AP, lateral, open-mouth odontoid, flexion, and extension views were obtained.
X-rays revealed an abnormal dens, with apparent separation of the odontoid process from the body of the axis. Lateral view in neutral position showed 8mm of posterior subluxation of C1 in relation to C2. Extension showed 11mm of posterior subluxation.
Case Photo #5
MRI was obtained and confirmed chronic odontoid synchondrosis fracture and osseous nonunion resulting in an os odontoideum, with 4mm of separation of the dens in relation to the body of C2. There was 2mm of posterior subluxation of the dens in relation to the posterior margin of C2, without canal compromise. No cervical herniation, cord compression, facet degeneration or foraminal compromise was present.
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