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<meta name="DC.Description" content="Type III (low) odontoid fractures may be subtle on initial plain film radiographic examination. We describe a sign on the routine open-mouth view, the laterally tilted dens, which has not been previously stressed in the radiologic literature, and is an important diagnostic sign of type III fractures of the odontoid process of the axis. In a series of 82 nontraumatized patients, no odontoid angle of less than 87 degrees (3 degrees from perpendicular) was observed. In a series of type III odontoid fractures, tilting of the dens in excess of 5 degrees was present in eight (67%) of 12 cases. This may be the only readily apparent finding on the initial cervical spine series. Of eight type III odontoid fractures in which an abnormal odontoid angle was identified, it was the only definite abnormality that could be recognized prospectively in two cases (25%) and that supported very subtle findings in two other cases (25%)." />
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      <h1 class="highwire-cite-title" id="page-title">The laterally tilted dens: a sign of subtle odontoid fracture on plain radiography.</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">W C Thomeier</span>, <span class="highwire-citation-author" data-delta="1">D C Brown</span> and <span class="highwire-citation-author" data-delta="2">S E Mirvis</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">May 1990,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">11 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(3) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">605-608; </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-4796--61610198252" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">W C Thomeier </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>Department of Diagnostic Radiology, Walter Reed Army Medical Center, Washington, DC 20307-5001.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=W%2BC%2BThomeier%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Thomeier%20WC&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AW%2BC%2BThomeier%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">D C Brown </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>Department of Diagnostic Radiology, Walter Reed Army Medical Center, Washington, DC 20307-5001.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=D%2BC%2BBrown%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Brown%20DC&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AD%2BC%2BBrown%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">S E Mirvis </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>Department of Diagnostic Radiology, Walter Reed Army Medical Center, Washington, DC 20307-5001.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S%2BE%2BMirvis%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Mirvis%20SE&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AS%2BE%2BMirvis%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div></div></div>  </div>

  
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      <div class="highwire-cite-title">The laterally tilted dens: a sign of subtle odontoid fracture on plain radiography.</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">W C</span> <span class="nlm-surname">Thomeier</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">D C</span> <span class="nlm-surname">Brown</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">S E</span> <span class="nlm-surname">Mirvis</span></span></span></div>
  
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