Northwestern University Feinberg School of Medicine

Orthopedic Teaching

Spine Case 10 Diagnosis

Odontoid Fracture


CT of the cervical spine is the test of choice for evaluating for cervical spine fractures.

Cervical spine x rays are much less sensitive. When used, AP, lateral, and open mouth views are obtained.

- C1 and C2 are often difficult to visualize and even more difficult when the cervical collar is left in place.

- Prevertebral soft tissue swelling (>10 mm at C1 or C2) on the lateral view may be the only finding sometimes. However up to 20% of those with C2 fractures stilldo not manifest this.

- The open mouth view, when done properly, gives the best view of the dens.