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Flexion-distraction, osseous-ligamentous (Chance variant) fracture of L1.

USU Teaching File MUTF - MedPix

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Flexion-distraction, osseous-ligamentous (Chance variant) fracture of L1.

History: 23 year-old active duty male who fell approximately 30 feet while intoxicated and attempting to climb into his barracks window. The patient lost consciousness with the fall and awoke in the hospital. The patient complains of lower back pain at the level of L1 that does not radiate. He denies pain elsewhere, and has no radicular symptoms.

Findings: See Image Captions

Exam: On physical exam, his lumbar spine is tender to palpation at L1. There is no stepoff or scoliosis. Remainder of spine is non-tender to palpation. All spinous processes were palpapated. CNII-XII intact. Sensation intact bilaterally in both upper and lower extremities with 5/5 strength throughout. 2+ reflexes (patella, Achilles, biceps, triceps) bilaterally in both upper and lower extremities. No Babinski.

No MeSH data available.


Sagital and axial T1 and fast spin-echo proton and T2:  Anterior wedge deformity of the L1 vertebral body with bone marrow edema with a low signal intensity horizontal linear signal in the mid-portion compatible with fracture which extends posteriorly through both pedicles into the lamina of the spinous process.  There is distraction of the posterior elements at the fracture cleft.  There is soft tissue edema adjacent to the spinous process and lamina along with bilateral transverse process fractures.
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MPX1177_synpic8703: Sagital and axial T1 and fast spin-echo proton and T2: Anterior wedge deformity of the L1 vertebral body with bone marrow edema with a low signal intensity horizontal linear signal in the mid-portion compatible with fracture which extends posteriorly through both pedicles into the lamina of the spinous process. There is distraction of the posterior elements at the fracture cleft. There is soft tissue edema adjacent to the spinous process and lamina along with bilateral transverse process fractures.


Flexion-distraction, osseous-ligamentous (Chance variant) fracture of L1.

USU Teaching File MUTF - MedPix

Sagital and axial T1 and fast spin-echo proton and T2:  Anterior wedge deformity of the L1 vertebral body with bone marrow edema with a low signal intensity horizontal linear signal in the mid-portion compatible with fracture which extends posteriorly through both pedicles into the lamina of the spinous process.  There is distraction of the posterior elements at the fracture cleft.  There is soft tissue edema adjacent to the spinous process and lamina along with bilateral transverse process fractures.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1177&req=5

MPX1177_synpic8703: Sagital and axial T1 and fast spin-echo proton and T2: Anterior wedge deformity of the L1 vertebral body with bone marrow edema with a low signal intensity horizontal linear signal in the mid-portion compatible with fracture which extends posteriorly through both pedicles into the lamina of the spinous process. There is distraction of the posterior elements at the fracture cleft. There is soft tissue edema adjacent to the spinous process and lamina along with bilateral transverse process fractures.

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Flexion-distraction, osseous-ligamentous (Chance variant) fracture of L1.

History: 23 year-old active duty male who fell approximately 30 feet while intoxicated and attempting to climb into his barracks window. The patient lost consciousness with the fall and awoke in the hospital. The patient complains of lower back pain at the level of L1 that does not radiate. He denies pain elsewhere, and has no radicular symptoms.

Findings: See Image Captions

Exam: On physical exam, his lumbar spine is tender to palpation at L1. There is no stepoff or scoliosis. Remainder of spine is non-tender to palpation. All spinous processes were palpapated. CNII-XII intact. Sensation intact bilaterally in both upper and lower extremities with 5/5 strength throughout. 2+ reflexes (patella, Achilles, biceps, triceps) bilaterally in both upper and lower extremities. No Babinski.

No MeSH data available.