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The Dens: Normal Development, Developmental Variants and Anomalies, and Traumatic Injuries
Accurate interpretation of cervical spine imagining can be challenging, especially in children and the elderly. The biomechanics of the developing pediatric spine and age-related degenerative changes predispose these patient populations to injuries centered at the craniocervical junction. In additio...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Medknow Publications & Media Pvt Ltd
2015
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4498315/ https://www.ncbi.nlm.nih.gov/pubmed/26199787 http://dx.doi.org/10.4103/2156-7514.159565 |
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author | O’Brien, William T Shen, Peter Lee, Paul |
author_facet | O’Brien, William T Shen, Peter Lee, Paul |
author_sort | O’Brien, William T |
collection | PubMed |
description | Accurate interpretation of cervical spine imagining can be challenging, especially in children and the elderly. The biomechanics of the developing pediatric spine and age-related degenerative changes predispose these patient populations to injuries centered at the craniocervical junction. In addition, congenital anomalies are common in this region, especially those associated with the axis/dens, due to its complexity in terms of development compared to other vertebral levels. The most common congenital variations of the dens include the os odontoideum and a persistent ossiculum terminale. At times, it is necessary to distinguish normal development, developmental variants, and developmental anomalies from traumatic injuries in the setting of acute traumatic injury. Key imaging features are useful to differentiate between traumatic fractures and normal or variant anatomy acutely; however, the radiologist must first have a basic understanding of the spectrum of normal developmental anatomy and its anatomic variations in order to make an accurate assessment. This review article attempts to provide the basic framework required for accurate interpretation of cervical spine imaging with a focus on the dens, specifically covering the normal development and ossification of the dens, common congenital variants and their various imaging appearances, fracture classifications, imaging appearances, and treatment options. |
format | Online Article Text |
id | pubmed-4498315 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-44983152015-07-21 The Dens: Normal Development, Developmental Variants and Anomalies, and Traumatic Injuries O’Brien, William T Shen, Peter Lee, Paul J Clin Imaging Sci Review Article Accurate interpretation of cervical spine imagining can be challenging, especially in children and the elderly. The biomechanics of the developing pediatric spine and age-related degenerative changes predispose these patient populations to injuries centered at the craniocervical junction. In addition, congenital anomalies are common in this region, especially those associated with the axis/dens, due to its complexity in terms of development compared to other vertebral levels. The most common congenital variations of the dens include the os odontoideum and a persistent ossiculum terminale. At times, it is necessary to distinguish normal development, developmental variants, and developmental anomalies from traumatic injuries in the setting of acute traumatic injury. Key imaging features are useful to differentiate between traumatic fractures and normal or variant anatomy acutely; however, the radiologist must first have a basic understanding of the spectrum of normal developmental anatomy and its anatomic variations in order to make an accurate assessment. This review article attempts to provide the basic framework required for accurate interpretation of cervical spine imaging with a focus on the dens, specifically covering the normal development and ossification of the dens, common congenital variants and their various imaging appearances, fracture classifications, imaging appearances, and treatment options. Medknow Publications & Media Pvt Ltd 2015-06-30 /pmc/articles/PMC4498315/ /pubmed/26199787 http://dx.doi.org/10.4103/2156-7514.159565 Text en Copyright: © 2015 Journal of Clinical Imaging Science http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Review Article O’Brien, William T Shen, Peter Lee, Paul The Dens: Normal Development, Developmental Variants and Anomalies, and Traumatic Injuries |
title | The Dens: Normal Development, Developmental Variants and Anomalies, and Traumatic Injuries |
title_full | The Dens: Normal Development, Developmental Variants and Anomalies, and Traumatic Injuries |
title_fullStr | The Dens: Normal Development, Developmental Variants and Anomalies, and Traumatic Injuries |
title_full_unstemmed | The Dens: Normal Development, Developmental Variants and Anomalies, and Traumatic Injuries |
title_short | The Dens: Normal Development, Developmental Variants and Anomalies, and Traumatic Injuries |
title_sort | dens: normal development, developmental variants and anomalies, and traumatic injuries |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4498315/ https://www.ncbi.nlm.nih.gov/pubmed/26199787 http://dx.doi.org/10.4103/2156-7514.159565 |
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