Kaufmann RA, Marzi I, Vogl TJ. Delayed diagnosis of isolated alar ligament rupture: A case report. World J Radiol 2015; 7(10): 357-360 [PMID: 26516433 DOI: 10.4329/wjr.v7.i10.357]
Corresponding Author of This Article
Robin A Kaufmann, MD, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, D-60590 Frankfurt am Main, Germany. robin.kaufmann@students.unibe.ch
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Radiol. Oct 28, 2015; 7(10): 357-360 Published online Oct 28, 2015. doi: 10.4329/wjr.v7.i10.357
Delayed diagnosis of isolated alar ligament rupture: A case report
Robin A Kaufmann, Ingo Marzi, Thomas J Vogl
Robin A Kaufmann, Thomas J Vogl, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Goethe University, D-60590 Frankfurt am Main, Germany
Ingo Marzi, Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, D-60590 Frankfurt am Main, Germany
Author contributions: Kaufmann RA was mainly responsible for writing and researching the paper; Vogl TJ was the involved radiologist and Marzi I the traumatologist.
Institutional review board statement: Not applicable for case reports in our instituion.
Informed consent statement: Patient gave informed consent to publication of case report.
Conflict-of-interest statement: No conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Robin A Kaufmann, MD, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, D-60590 Frankfurt am Main, Germany. robin.kaufmann@students.unibe.ch
Telephone: +49-69-63017277 Fax: +49-69-63017258
Received: March 30, 2015 Peer-review started: April 8, 2015 First decision: May 13, 2015 Revised: June 23, 2015 Accepted: June 30, 2015 Article in press: July 2, 2015 Published online: October 28, 2015
Abstract
Ligament disruptions at the craniovertebral junction are typically associated with atlantoaxial rotatory dislocation during upper cervical spine injuries and require external orthoses or surgical stabilization. Only in few patients isolated ruptures of the alar ligament have been reported. Here we present a further case, in which the diagnosis was initially obscured by a misleading clinical symptomatology but finally established six month following the trauma, demonstrating the value of contrast-enhanced high resolution 3 Tesla magnetic resonance imaging in identifying this particular lesion.
Core tip: Upper cervical spine injuries are common and bear a relevant medical and socioeconomic impact. While most of such lesions are related to atlantoaxial rotatory dislocation, thus far only few patients with isolated alar ligament ruptures have been reported. This particular trauma is a challenge to both clinicians and radiologists and diagnosis might thus be delayed. Here we present a further case of a young adult and discuss the value of sequential contrast-enhanced magnetic resonance imaging in establishing this diagnosis at a late stage and in the follow-up of a subsequently prolonged recovery.
