Occipitocervical fracture-subluxation

Except for frank occipitoatlantal dislocation, injuries of the occipitovertebral junction usually are invisible on the lateral cervical spine radiograph and are heralded by changes in the cervicocranial prevertebral soft tissues. The latter require computed tomography for further evaluation. With a minimal degree of subluxation of the occipital condyles relative to C1, the appearance on the lateral radiograph may be deceptively normal. The occipital condyles are poorly seen on the lateral plain films of the cervical spine owing to overlying structures, and occipital condylar fractures may not be visible.