SPINE TRAUMA RADIOLOGY: HOW TO Dx A FACET DISLOCATION ON CT (VIDEO)

Facet joint trauma is a spectrum, not a single injury — here's where dislocation sits on it

• Facet joint injury in spinal trauma ranges from diastasis, to subluxation, to perched facets, to complete dislocation.
• Recognizing the normal facet joint appearance is the reference point for spotting displacement further along that spectrum.
• In this video we walk through the normal facet joint at C7-T1, then contrast it with a complete facet dislocation at C6-C7.

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• Diastasis — widening of the facet joint space.
• Subluxation — partial loss of the normal articular alignment.
• Perched facet — the inferior articular process sits balanced on the tip of the superior articular process below, short of full dislocation.
• Dislocation — complete loss of articulation, with the inferior articular process displaced anteriorly and uncovering the joint.

• Facet joint trauma spans a spectrum: diastasis, subluxation, perched facets, and dislocation.
• A normal facet joint has the inferior articular process of the vertebra above lying posterior to the superior articular process of the vertebra below, with the joint space preserved.
• Complete facet dislocation shows the inferior articular process displaced anteriorly, uncovering the joint entirely.
• Knowing the normal facet position is what lets that anterior uncovering be recognized as dislocation rather than a lesser injury on the spectrum.