Oppenheimer's ossicle

Case contributed by Dr Abraão Kupske

Presentation

Crohn's disease, chronic low back pain. No history of trauma.

Patient Data

Age: 60 years
Gender: Male
CT

Just superior to the left L3 superior articular process, there is a small, corticalized ossificiation anterior to the ligamentum flavum. This causes minor spinal canal stenosis and narrowing of the ipsilateral L2/3 neural foramen.

Additionally, there is degenerative disc disease and dense material within the intervertebral disks (storage disease?).

Case Discussion

Oppenheimer’s ossicles are generally smaller than 1 cm. They can be round, oval, or triangular, with smooth corticated margins at the site of separation.

They should not be mistaken for a facet fracture. Accessory ossicles at the superior joint facet may also occur.

The most significant clinical finding of these ossicles is lower back pain, usually caused by associated spinal canal stenosis.

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