A Pitfall in Neck Pain: Occult Odontoid Fracture

Cheng T. Hsieh, Yung Hsiao Chiang, Tai Feng Chiu, Jui Ming Sun, Cheng F. Chang

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Type III odontoid fractures of the axis are the second most common injuries of the cervical spine. Most of these result from motor vehicle accidents and falls. Occult odontoid fractures without preceding trauma are rarely reported in the literature and may be difficult to diagnose. We report the case of a healthy patient who had no history of trauma, but sustained sudden pain in the neck and guarding during head movement after sleep. Initial radiographs of the cervical spine including open-mouth, anterior-posterior, and lateral views did not reveal any obvious fractures. Type III odontoid fracture was uneventfully diagnosed via high-quality three-dimensional reconstruction of computed tomography. The possible mechanism was hyperextension of the neck during the change from the supine to the sitting position. Type III odontoid fractures can occur in the absence of major trauma. The usefulness of computed tomography is emphasized and the literature is also reviewed.

Original languageEnglish
Pages (from-to)593-596
Number of pages4
JournalJournal of Emergency Medicine
Volume38
Issue number5
DOIs
Publication statusPublished - Jun 2010
Externally publishedYes

Fingerprint

Closed Fractures
Neck Pain
Wounds and Injuries
Spine
Tomography
Head Movements
Motor Vehicles
Posture
Accidents
Mouth
Sleep
Neck

Keywords

  • cervical spine
  • occult
  • odontoid fracture

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

A Pitfall in Neck Pain : Occult Odontoid Fracture. / Hsieh, Cheng T.; Chiang, Yung Hsiao; Chiu, Tai Feng; Sun, Jui Ming; Chang, Cheng F.

In: Journal of Emergency Medicine, Vol. 38, No. 5, 06.2010, p. 593-596.

Research output: Contribution to journalArticle

Hsieh, Cheng T. ; Chiang, Yung Hsiao ; Chiu, Tai Feng ; Sun, Jui Ming ; Chang, Cheng F. / A Pitfall in Neck Pain : Occult Odontoid Fracture. In: Journal of Emergency Medicine. 2010 ; Vol. 38, No. 5. pp. 593-596.
@article{944af97e945f4ef296edf58e3082b65e,
title = "A Pitfall in Neck Pain: Occult Odontoid Fracture",
abstract = "Type III odontoid fractures of the axis are the second most common injuries of the cervical spine. Most of these result from motor vehicle accidents and falls. Occult odontoid fractures without preceding trauma are rarely reported in the literature and may be difficult to diagnose. We report the case of a healthy patient who had no history of trauma, but sustained sudden pain in the neck and guarding during head movement after sleep. Initial radiographs of the cervical spine including open-mouth, anterior-posterior, and lateral views did not reveal any obvious fractures. Type III odontoid fracture was uneventfully diagnosed via high-quality three-dimensional reconstruction of computed tomography. The possible mechanism was hyperextension of the neck during the change from the supine to the sitting position. Type III odontoid fractures can occur in the absence of major trauma. The usefulness of computed tomography is emphasized and the literature is also reviewed.",
keywords = "cervical spine, occult, odontoid fracture",
author = "Hsieh, {Cheng T.} and Chiang, {Yung Hsiao} and Chiu, {Tai Feng} and Sun, {Jui Ming} and Chang, {Cheng F.}",
year = "2010",
month = "6",
doi = "10.1016/j.jemermed.2007.08.059",
language = "English",
volume = "38",
pages = "593--596",
journal = "Journal of Emergency Medicine",
issn = "0736-4679",
publisher = "Elsevier USA",
number = "5",

}

TY - JOUR

T1 - A Pitfall in Neck Pain

T2 - Occult Odontoid Fracture

AU - Hsieh, Cheng T.

AU - Chiang, Yung Hsiao

AU - Chiu, Tai Feng

AU - Sun, Jui Ming

AU - Chang, Cheng F.

PY - 2010/6

Y1 - 2010/6

N2 - Type III odontoid fractures of the axis are the second most common injuries of the cervical spine. Most of these result from motor vehicle accidents and falls. Occult odontoid fractures without preceding trauma are rarely reported in the literature and may be difficult to diagnose. We report the case of a healthy patient who had no history of trauma, but sustained sudden pain in the neck and guarding during head movement after sleep. Initial radiographs of the cervical spine including open-mouth, anterior-posterior, and lateral views did not reveal any obvious fractures. Type III odontoid fracture was uneventfully diagnosed via high-quality three-dimensional reconstruction of computed tomography. The possible mechanism was hyperextension of the neck during the change from the supine to the sitting position. Type III odontoid fractures can occur in the absence of major trauma. The usefulness of computed tomography is emphasized and the literature is also reviewed.

AB - Type III odontoid fractures of the axis are the second most common injuries of the cervical spine. Most of these result from motor vehicle accidents and falls. Occult odontoid fractures without preceding trauma are rarely reported in the literature and may be difficult to diagnose. We report the case of a healthy patient who had no history of trauma, but sustained sudden pain in the neck and guarding during head movement after sleep. Initial radiographs of the cervical spine including open-mouth, anterior-posterior, and lateral views did not reveal any obvious fractures. Type III odontoid fracture was uneventfully diagnosed via high-quality three-dimensional reconstruction of computed tomography. The possible mechanism was hyperextension of the neck during the change from the supine to the sitting position. Type III odontoid fractures can occur in the absence of major trauma. The usefulness of computed tomography is emphasized and the literature is also reviewed.

KW - cervical spine

KW - occult

KW - odontoid fracture

UR - http://www.scopus.com/inward/record.url?scp=77952543085&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77952543085&partnerID=8YFLogxK

U2 - 10.1016/j.jemermed.2007.08.059

DO - 10.1016/j.jemermed.2007.08.059

M3 - Article

C2 - 18281177

AN - SCOPUS:77952543085

VL - 38

SP - 593

EP - 596

JO - Journal of Emergency Medicine

JF - Journal of Emergency Medicine

SN - 0736-4679

IS - 5

ER -