Case Study

CT – Normal CT of the cervical spine post trauma with pain and ambulatory deficits in a puppy

History of trauma (falling off bed); febrile, lethargic, anorexic, unable to stand – holds body in a C-shape.

Physical exam: thin. Non ambulatory, very painful when neck is manipulated, dulled mentation.

CBC/Chem: HCT 25.3, HGB 6.9, Retic 4.8, PLT 105; Na 173, Cl 127, NH3 wnl

History of trauma (falling off bed); febrile, lethargic, anorexic, unable to stand – holds body in a C-shape.

Physical exam: thin. Non ambulatory, very painful when neck is manipulated, dulled mentation.

CBC/Chem: HCT 25.3, HGB 6.9, Retic 4.8, PLT 105; Na 173, Cl 127, NH3 wnl

DX

An underlying cause to the clinical presentation could not be identified in the CT of the cervical spine. Only the expected age related findings were noted.

Image Interpretation

CT of the cervical spine – The degree of skeletal maturity appears to be appropriate (exact age of dog unknown).
Neither the bone nor the soft tissue window reveals any evidence of traumatic bone or
soft tissue injury along the skull and cervical spine. The vertebral alignment including
the atlantooccipital as well as the atlantoaxial transition is appropriate. No angular
deformity of the cervical spine is noted.
A mild subcutaneous emphysema is noted level with the scapulae which is consistent
with an injection site.

Outcome

Given the history a traumatic atlantoaxial event could have caused transient
compressive myelopathy, which is not detectable via CT. In case of lacking clinical
improvement an MRI should be considered for further definition and to rule out
parenchymal central nervous pathology.