Spine imaging: Jefferson fracture: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Spine imaging: Jefferson fracture

Sample item

After a diving injury, an open-mouth view shows lateral displacement of both lateral masses of C1 relative to C2. What is the injury?

AClay shoveler fractureBHangman fracture of C2CJefferson burst fracture of C1DOdontoid type II fracture

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Jefferson burst fracture of C1

A Jefferson fracture is a burst of the ring of C1 caused by axial loading, and the lateral masses spread beyond the C2 margins on the open-mouth view. Hangman fracture is a bilateral pars fracture of C2. Clay shoveler fracture is an avulsion of a lower cervical spinous process.

Option by option

A. Clay shoveler fracture
A clay shoveler fracture involves the C7 or T1 spinous process.
B. Hangman fracture of C2
A hangman fracture involves the C2 pars.
C. Jefferson burst fracture of C1 (correct)
Correct. Axial loading splays the lateral masses in a C1 burst fracture.
D. Odontoid type II fracture
An odontoid fracture involves the dens.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is C, Jefferson burst fracture of C1. A Jefferson fracture is a burst of the ring of C1 caused by axial loading, and the lateral masses spread beyond the C2 margins on the open-mouth view.

Why is "Clay shoveler fracture" not the answer?

A clay shoveler fracture involves the C7 or T1 spinous process.

Why is "Hangman fracture of C2" not the answer?

A hangman fracture involves the C2 pars.

Why is "Odontoid type II fracture" not the answer?

An odontoid fracture involves the dens.

What concept does this question test?

It tests Spine imaging: Jefferson fracture in Radiology. Hangman fracture is a bilateral pars fracture of C2. Clay shoveler fracture is an avulsion of a lower cervical spinous process.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Spine imaging: Jefferson fracture?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.