Pseudospread of the atlas

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Pseudospread of the Atlas 1

  • Defined: > 2 mm total overlap of the two C1 lateral masses on C2 on AP open- mouth view.
  • Prevalence: 91-100% during second year of life
    • Youngest: 3 months
    • Oldest: 4 years
    • 2mm during first year.
    • 4mm during the second.
    • 6mm during the third.
    • Decreases after that.
    • Max is 8m
  • Trauma is not a contributing factor
  • Neck rotation can stimulate the appearance of a Jefferson fracture.
  • Probably a result of disproportionate grown of the atlas on the axis. 'Misdiagnosed as JEFFERSON FRACTURE.'
    • Rarely occurs prior to teen years.


  • If suspicion for fracture is high: CT scan through C1 can resolve the issue.

1. Suss RA, Zimmerman RD, Leeds NE. Pseudospread of the atlas: False sign of jefferson fracture in young children. AJR Am J Roentgenol. 1983;140:1079-1082


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