Occipital condyle fractures: clinical presentation and radiologic detection.

PURPOSE: To describe the CT findings in occipital condyle fractures in patients suffering craniocervical trauma.

METHODS

Six occipital condyle fractures in five patients were analyzed. Because of clinical or plain-film findings, the craniocervical junction in each patient was imaged using thin-section, high-resolution CT. Axial data were reformatted in the coronal plane or in both coronal and sagittal planes. Clinical and radiologic findings associated with occipital condyle fractures reported in the English medical literature were correlated with our cases to determine conclusive predictive features indicating condylar injury.

RESULTS

Two avulsion (type III) fractures in two patients, two compression (type I) fractures in one patient, and two compression fractures in two patients were diagnosed by CT. Specific predictive features indicating occipital condyle fracture could not be confirmed.

CONCLUSIONS

CT greatly facilitates diagnosing and typing of occipital condyle fractures. Nonspecific parameters promoting CT after trauma are unexplained persistent upper-neck pain with normal plain-film findings, lower cranial nerve palsies, spasmodic torticollis, retropharyngeal or prevertebral soft-tissue swelling, and fractures of the atlas or axis.