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American Journal of Roentgenology, Vol 140, Issue 6, 1079-1082
Copyright © 1983 by American Roentgen Ray Society

Articles

Pseudospread of the atlas: false sign of Jefferson fracture in young children

RA Suss, RD Zimmerman, and NE Leeds

Jefferson fractures are rare prior to teen-age. Three young children examined after trauma exhibited the characteristic spread appearance of the atlas, but fractures were excluded radiographically and clinically. A retrospective study demonstrated a similar appearance, termed "pseudospread," in most children aged 3 months to 4 years, including over 90% during the second year. Pseudospread results from a discrepancy between the "neural" growth pattern of the atlas and the "somatic" pattern of the axis. An "atlas spread index" is defined and a normal range presented. When an atlas fracture is suggested by apparent lateral spread of the lateral atlas masses, computed tomography is useful to demonstrate an intact atlas ring.
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Copyright © 1983 by the American Roentgen Ray Society.