Differential diagnosis of pediatric cervical spine instability

• Atlanto axial rotatory subluxation
• Atlanto axial instability
• Atlanto occipital instability
• Pseudosubluxation of cervical spine

Approach to the differential diagnosis of cervical spine instability:

• Atlanto axial rotatory subluxation is a rotation of the C1 vertebral body on the C2 vertebral body
• Atlanto axial instability is excessive anterior translation of the C1 vertebral body on the C2 vertebral body
• Atlanto occipital instability is excessive posterior translation of the occipital condyles on the lateral masses of the C1 vertebral body
• Pseudosubluxation of cervical spine is a normal finding in the upper cervical spine and needs to be distinguished from fracture / dislocation