Occipital spur

Last revised by Dr Pablo Lorenzzoni on 08 Jun 2022

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.

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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Cases and figures

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