Differential diagnosis of pediatric cervical spine fractures

Approach to the differential diagnosis of cervical spine fractures:

  • Make sure you can see C7-T1
  • Check cevical-basilar alignment / relationships
  • Check prevertebral soft tissues for hematoma
  • Check open mouth odontoid / coronal view for atlanto axial rotatory subluxation and C1 / Jefferson fx
  • Check alignment of cervical spine by checking 4 lines going through:
    — Anterior part of vertebral bodies
    — Posterior part of vertebral bodies = anterior border of spinal canal
    — Posterior border of spinal canal
    — Posterior border of spinous processes
  • Check alignment of articular facets and neuro foramina
  • Check sinuses for air fluid levels and other skull structures for fractures