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Occipital spurs, also known as occipital knobs, occipital buns, chignon hooks or inion hooks, are anatomical variants that represent an exaggerated external occipital protuberance 1.
It is common in males and hence is often used in forensic investigations for gender determination 1.
It is an anatomical variant which is usually noticed incidentally radiographically, although it can become symptomatic with affected patients describing a tender bony swelling at the back of the neck causing pain especially while lying down 1.
Three types have been described:
- type I: smooth type
- type II: crest type
- type III: spine type
Dimensions of the occipital spur are measured as width at its base and standing height above the normal outline of occipital bone.
Treatment and prognosis
Soft pillows and analgesia are usually trialed before surgery and may be effective. However, in patients whose symptoms fail conservative management, surgical excision and smoothening of the bone leads to adequate recontouring and relieves the symptoms 1.
On imaging consider
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- 2. Shahar D, Sayers MGL. A morphological adaptation? The prevalence of enlarged external occipital protuberance in young adults. (2016) Journal of Anatomy. 229 (2): 286. doi:10.1111/joa.12466 - Pubmed
- 3. Porrino J, Sunku P, Wang A, Haims A, Richardson M. Exophytic External Occipital Protuberance Prevalence Pre- and Post-IPhone Introduction: A Retrospective Cohort. Yale J Biol Med. 2021;94(1):65-71. PMC7995952 - Pubmed