Os Odontoideum.

Fielding, J W; Hensinger, Robert N.; Hawkins, R J

doi:10.2106/00004623-198062030-00007

Cited by 300 publications

(223 citation statements)

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“…Our findings regarding the significance of prior trauma to later presentation with os odontoideum are opposite to those of Fielding et al (6% vs 49%) [2]. Most of the cases in their series gave a general history of prior trauma.…”

Section: Discussioncontrasting

confidence: 99%

“…Two other large series of 35 patients [2] and 24 patients [12] are in the literature. Our findings regarding the significance of prior trauma to later presentation with os odontoideum are opposite to those of Fielding et al (6% vs 49%) [2].…”

Section: Discussionmentioning

confidence: 99%

“…The criteria of Fielding et al [2] were used to differentiate os odontoideum from non-union after a fracture of the odontoid. In os odontoideum there is a wide gap between the os and the axis.…”

Section: Methodsmentioning

confidence: 99%

“…In favour of a post-traumatic aetiology are the reported cases with radiologically documented progression from a normal odontoid to os odontoideum after significant traumatic injury [4,3,5,10,7]. In addition, a large series reported a high incidence with a previous history of significant trauma: 17 of 35 [2]. Only four of these, however, had specific trauma to the head or neck.…”

Section: Introductionmentioning

confidence: 99%

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The jigsaw sign. A reliable indicator of congenital aetiology in os odontoideum

2004

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IntroductionBoth congenital and post-traumatic aetiologies for os odontoideum have been proposed in the literature. The debate regarding aetiology can lead to confusion in a medicolegal setting and even lead to inappropriate treatment. In favour of a post-traumatic aetiology are the reported cases with radiologically documented progression from a normal odontoid to os odontoideum after significant traumatic injury [4,3,5,10,7]. In addition, a large series reported a high incidence with a previous history of significant trauma: 17 of 35 [2]. Only four of these, however, had specific trauma to the head or neck.The congenital-aetiology argument is supported by the condition's association with several congenital syndromes Abstract There is evidence in the literature for both a congenital and a post-traumatic aetiology for os odontoideum. In no series published to date has CT been used to aid in the diagnosis. This is a prospective study of the history of trauma and presence of diagnostic features on CT of 18 consecutive cases with os odontoideum. Our objective was to derive clinically useful radiological features enabling accurate differentiation between congenital and post-traumatic aetiologies. A mid-sagittal CT reconstruction of the atlanto-dens joint was obtained. Hypertrophy of the anterior arch of the atlas was quantified by measurement of the arch-peg-area ratio. The presence of dysplastic features (a positive "jigsaw" sign) of the atlanto-axial joint were noted. These included narrowing of the cartilage space and interdigitation of the two joint surfaces. A history of a potential traumatic aetiology was only obtained in one of the 18 (6%) in our series. A significant elevation of the arch-peg ratio was found when comparing this series to 85 controls. And a positive jigsaw sign was observed in 75% of cases. These features were not seen in paediatric cases of atlantoaxial instability, including odontoid non-union. In conclusion, an elevated arch-peg ratio and the presence of a jigsaw sign are sensitive and specific diagnostic criteria for os odontoideum. This series supports a congenital aetiology for this condition.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The jigsaw sign. A reliable indicator of congenital aetiology in os odontoideum

2004

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“…Atlantoaxial subluxation associated with os odontoideum is rare, and an associated posterior subluxation is rare [15]. Fielding et al [3] demonstrated that posterior instability was observed in only 5 (14%) of 35 patients with os odontoideum. The main etiology of os odontoideum is the congenital anomalies of the odontoid process or trauma.…”

Section: Discussionmentioning

confidence: 99%

Posterior atlantoaxial subluxation due to os odontoideum combined with cervical spondylotic myelopathy : a case report

et al. 2007

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In patients with os odontoideum and posterior atlantoaxial subluxation are extremely rare. No reports have described posterior atlantoaxial subluxation associated with os odontoideum combined with cervical spondylotic canal stenosis, both of which require surgical treatment. We report one case of a 75-year-old female who underwent arthrodesis between the occiput and C3 using a hook-and-rod system and also a double-door laminoplasty from levels C3 to C7. The claw mechanism was applied between the C2 lamina and the C3 inferior articular process. The posterior atlantoaxial subluxation was completely reduced by the method that the rod gradually pushed the posterior arch of C1 anteriorly during connection to the occiput. Twelve months after surgery, the patient showed improvement in preoperative clumsiness and gait disturbance, and the latest plain radiographs showed solid osseous fusion, with no loss of correction or instrumentation failure.

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Evolution of chronic recurrent multifocal osteitis toward spondylarthropathy over the long term

Vittecoq

Said

Michot

et al. 2000

Arthritis & Rheumatism

133

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Objective. To retrospectively assess, with a sufficiently long followup (mean 11.6 years; median 9 years), the long-term outcome of chronic recurrent multifocal osteitis (CRMO), a multifocal, inflammatory bone disease.Methods. Patients included were 8 children/ adolescents and 7 adults with no family history of rheumatic disease who had been diagnosed as having CRMO between 1979 and 1995. Ten patients had undergone at least 1 bone biopsy of the lesions, with histologic examination and multiple cultures. In 1996, in addition to an in-depth interview, 12 patients underwent an extensive physical examination, laboratory evaluation, HLA-A, B, C, and DR typing, bone radiography and scintigraphy, and computed tomography scan of the sternoclavicular and sacroiliac joints.Results. Remission was observed in 3 patients. The other 12 patients developed various associations of vertebral (n ‫؍‬ 10), sacroiliac (n ‫؍‬ 6), anterior thoracic (n ‫؍‬ 7), peripheral articular (n ‫؍‬ 2), enthesopathic (n ‫؍‬ 4), or dermatologic (palmoplantar pustulosis in 3 cases and psoriasis in 2) involvements. Spine involvement was the most common and occurred the earliest (median time to appearance after the onset of osteitis 5.63 years). Clinical sacroiliitis was always unilateral. No patients carried the HLA-B27 haplotype. CRMO responded well to nonsteroidal antiinflammatory drugs. Twelve patients met the European Spondylarthropathy Study Group criteria for spondylarthopathy.

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Os Odontoideum.

Cited by 300 publications

References 0 publications

The jigsaw sign. A reliable indicator of congenital aetiology in os odontoideum

The jigsaw sign. A reliable indicator of congenital aetiology in os odontoideum

Posterior atlantoaxial subluxation due to os odontoideum combined with cervical spondylotic myelopathy : a case report

Evolution of chronic recurrent multifocal osteitis toward spondylarthropathy over the long term

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