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Figure 3. (a) Lateral plain radiograph of the upper cervical spine in a rheumatoid patient following trauma. A fracture of the posteriorring of C1 is clearly demonstrated. There is also a possible fracture across the base of the dens but this area is not as well visualized. (b) Open mouth view of the dens. There is suspicion of a fracture through the base of the dens. (c) Sagittal multislice CT (MSCT) image confirms an undisplaced type II dens fracture. (d) Coronal MSCT scan of the dens clearly demonstrating type II fracture through the base of the dens. (e) A fracture through the anterior part of the C1 ring is demonstrated on the axial MSCT image. This was not demonstrated on any of the plain radiographs.
