Cervical spine unilateral facet dislocation with bow tie sign

The plain x-ray of the cervical spine in the lateral projection reveals unilateral malalignment of the facets of C3 (arrowheads) compared with subjacent column which are widely separated resulting in the bow tie appearance of the posterior elements as they line up (D, red overlay). Associated mild subluxation is present. The arrows show normal alignment of the facet joints of C4, C5, and C6. These findings are reminiscent of a unilateral facet dislocation.