Wackenheim line

Last revised by Henry Knipe on 11 Apr 2024

Citation, DOI, disclosures and article data

Citation:

Venkatesh M, Knipe H, Kearns C, et al. Wackenheim line. Reference article, Radiopaedia.org (Accessed on 23 Apr 2024) https://doi.org/10.53347/rID-25674

DOI:

https://doi.org/10.53347/rID-25674

Permalink:

https://radiopaedia.org/articles/25674

rID:

25674

Article created:

2 Nov 2013, Manchikanti Venkatesh

Disclosures:

At the time the article was created Manchikanti Venkatesh had no recorded disclosures.

View Manchikanti Venkatesh's current disclosures

Last revised:

11 Apr 2024, Henry Knipe ◉ ◈

Disclosures:

At the time the article was last revised Henry Knipe had the following disclosures:

Integral Diagnostics, Shareholder (ongoing)
Micro-X Ltd, Shareholder (ongoing)

These were assessed during peer review and were determined to not be relevant to the changes that were made.

View Henry Knipe's current disclosures

Revisions:

6 times, by 5 contributors - see full revision history and disclosures

Systems:

Musculoskeletal, Spine

Sections:

Gamuts

Tags:

case, case3

Synonyms:

Clival canal line
Wackenheims clival canal line
Clivus canal line
Wackenheims clivus canal line
Basilar line

The Wackenheim line, also known as the clivus canal line or basilar line, can be used to assess for atlanto-occipital dissociation.

Measurement

The Wackenheim line is the caudal extension of a line drawn along the posterior cortex of the clivus on lateral cervical spine radiographs ¹.

Interpretation

On lateral cervical spine radiographs:

normally, the tip of the dens is ventral and tangential to this line
in basilar invagination, the odontoid process is above this line
in posterior atlanto-occipital dislocation, the line will extend posterior to the odontoid process
in anterior atlanto-occipital dislocation, the line will extend through the center of the odontoid process or more anterior

Interpretation may be limited by significant variation with neck flexion, and poor correlation with CT imaging ¹. It has low sensitivity but high specificity for atlanto-occipital dissociation ³.