Oppenheimer ossicles are accessory ossicles associated with the facet joints and are found in ~4% (range 1-7%) of lumbar spines 1.
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Gross anatomy
Oppenheimer ossicles predominantly occur as a single, unilateral ossicle of the inferior articular processes of the lumbar spine although they can also occur at the superior articular process ref.
Radiographic features
Best seen on sagittal CT and MR images and can be easily mistaken on thick axial slices.
Oppenheimer ossicles are seen in the lumbar spine, most notably at L2 and L3 levels 2. They appear as smoothly corticated structures that may sometimes be lined by articular cartilage. The synovial space of the adjacent facet joint may communicate with the cleft between the ossicle and the articular process 2.
They may be associated with other vertebral arch malformations, such as articular process hypoplasia 2.
Development
Oppenheimer ossicles are thought to arise as a result of the non-union of an articular process secondary ossification center. These ossicles should fuse between the ages of 17 and 25 years ref.
History and etymology
Oppenheimer nodules were first described by Albert Oppenheimer in 1942 3.
Clinical importance
usually asymptomatic and discovered incidentally on imaging 2.
not to be confused with an articular process fracture: an Oppenheimer ossicle will demonstrate regular, well-defined corticated margins
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