Atlanto Axial Rotatory Subluxation

  • Etiology: traumatic or inflammatory from upper respiratory infection / head and neck infection
  • Imaging: C1 is rotated to left or right on C2

Cases of Atlanto Axial Rotatory Subluxation

CT of atlanto-axial rotatory subluxation
Axial CT without contrast of the cervical spine shows the C1 vertebral body rotated to the left approximately 45 degrees in relation to the C2 vertebral body.
CT of atlanto-axial rotatory subluxation
3D CT without contrast of the cervical spine shows the C1 vertebral body rotated to the left approximately 30 degrees in relation to the C2 vertebral body.
CT of atlanto-axial rotatory subluxation due to retropharyngeal abscess
Axial images with bone windows from a CT with contrast of the neck shows the C1 vertebral body (above left) rotated approximately 30 degrees to the right in relation to the C2 vertebral body (above right). Axial image with soft tissue windows (below) from the same CT shows a low density fluid collection with an enhancing rim to the left of midline in the retropharyngeal space.
CT of atlanto-axial rotatory subluxation due to juvenile idiopathic arthritis
Axial images from a CT without contrast of the cervical spine shows the C1 vertebral body rotated to the left approximately 45 degrees (top) in relation to the C2 vertebral body (middle). A MIP image (bottom) better demonstrates the rotation of C1 on C2.
CT of atlanto axial rotatory subluxation
Axial CT without contrast of the cervical spine obtained after the accident shows C1 vertebral body rotated 45 degrees to the right (upper left) on the C2 vertebral body (lower left). Axial CT without contrast of the cervical spine obtained 1 day later shows C1 vertebral body now normally aligned (upper right) with the C2 vertebral body (lower right)