The value of retropharyngeal swelling in the diagnosis of fractures of the Atlas.

The Jefferson or bursting fracture of the atlas is frequently overlooked. This is because neurological deficit is usually absent and physical findings are nonspecific. In addition, diagnosis of this fracture cannot be made from the lateral radiograph of the cervical spine. Increase in the retropharyngeal soft-tissue space is valuable both as an indication of upper cervical spine trauma and in distinguishing a Jefferson fracture from the more common fracture of the posterior arch of the atlas. A case history illustrating these features and the radiological diagnosis is presented and discussed.