Persistent ossiculum terminale
Citation, DOI, disclosures and article data
At the time the article was created Frank Gaillard had no recorded disclosures.
View Frank Gaillard's current disclosuresAt the time the article was last revised Mohd Ashyiraff Ilani Bin Ismail had no financial relationships to ineligible companies to disclose.
View Mohd Ashyiraff Ilani Bin Ismail's current disclosures- Bergman's ossicle
- Ossiculum terminale of Bergmann
- os terminale
The ossiculum terminale appears as a secondary ossification center of the dens between 3-6 years and normally fuses by 12 years. Failure of fusion results in a persistent ossiculum terminale (also called Bergmann's ossicle or ossiculum terminale of Bergmann) and is considered a normal anatomical variant of the axis. It is important not to misinterpret this anatomical variant with dens fracture.
It lies above the alar ligament and is therefore considered to be stable and it very rarely causes symptoms.
Radiographic features
small, well-corticated ossicle at the tip of the dens
usually in the midline
dens is typically normal in height 4
Differential diagnosis
type 1 odontoid fracture
References
- 1. Karwacki G & Schneider J. Normal Ossification Patterns of Atlas and Axis: A CT Study. AJNR Am J Neuroradiol. 2012;33(10):1882-7. doi:10.3174/ajnr.A3105 - Pubmed
- 2. Suchomel P, Choutka O. Reconstruction of Upper Cervical Spine and Craniovertebral Junction. Springer. ISBN:B008CLYMRG. Read it at Google Books - Find it at Amazon
- 3. Cramer GD, Darby SA. Basic and Clinical Anatomy of the Spine, Spinal Cord, and ANS. Mosby. ISBN:B005BQ4PEK. Read it at Google Books - Find it at Amazon
- 4. Smoker W. Craniovertebral Junction: Normal Anatomy, Craniometry, and Congenital Anomalies. Radiographics. 1994;14(2):255-77. doi:10.1148/radiographics.14.2.8190952 - Pubmed
- 5. Offiah C & Day E. The Craniocervical Junction: Embryology, Anatomy, Biomechanics and Imaging in Blunt Trauma. Insights Imaging. 2017;8(1):29-47. doi:10.1007/s13244-016-0530-5 - Pubmed
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