File:Chance fracture (Radiopaedia 38398-40475 Axial lung window 1).jpeg

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Summary:

Description
  • Radiopaedia case ID: 38398
  • Image ID: 14620172
  • Image stack position: 1/2
  • Plane projection: Axial
  • Aux modality: lung window
  • Modality: CT
  • System: Trauma
  • Findings: Devastating vertebral injuries at the levels of T6-T7-T8. Starting with the most intact vertebral body at T8 - there is anterosuperior wedge shaped destruction of the anterior column with marked bony loss. The middle column, in particular its interface with the spinal canal appears undisrupted, although minimally displaced bony injury to the posterior elements at this level is noted. There is a chance fracture of T7. This is associated with superior/posterior dislocation of the T7 vertebral body. Some bony fragmentation persists in the original anatomical position of the T7 body (particularly of note is an anteroinferior fragment of T7 still attached to an anterosuperior fragment of T8), otherwise the superior aspect of the T7 body has been dislocated and retropulsed into the paraspinal musculature and subcutaneous soft tissues. T6 is not able to be seen as an identifiable structure in this limited series of images. Suffice to say it does not exist in its normal anatomical location, and it's obliterated components likely make up part of the retropulsed fragmentation that is seen in the region of injury. Hematoma and soft tissue swelling immediately anterior to the level of injury is noted. The great vessels in this area are not completely imaged (plus it's a non contrast scan), but appear to have escaped significant injury. Spinous process fracture of T3 is noted. Axial lung window images demonstrate bilateral hemothoraces with bilateral parenchymal lung injuries. Although poorly defined due to lung window settings, the retropulsion of the T7 (and T6?) vertebral bodies can be seen in the paraspinal musculature. Obliteration of the spinal canal at this level is evident.
Date Published: 19th Jul 2015
Source https://radiopaedia.org/cases/chance-fracture-5
Author Edward Oates
Permission
(Permission-reusing-text)		 http://creativecommons.org/licenses/by-nc-sa/3.0/

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current21:15, 4 August 2021Thumbnail for version as of 21:15, 4 August 2021901 × 738 (159 KB)Fæ (talk | contribs)Radiopaedia project rID:38398 (batch #7313-4 B1)

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