Dens fracture

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Posted on 11/17/2009

 A 79 year old female with a history of RA and parkinson's dx presents to the ED with a syncopal episode. She fell from a standing height and hit the back of her head. She was unable to stand and called EMS via medical alert signal when she awoke. She is complaining of midline neck and head pain that is worse when she rotates her neck. She does not have any focal deficits. She was not intoxicated. She has normal mental status. GCS= 15. She has pain when palpating midline C2-C4. She does not have any long bone injuries, but has rib pain and tenderness on the left side. Being an astute ED resident you order a CT of the neck. What do you see? (hint look at C2)

Dens fracture type II.jpg