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Os odontoideum: a significant radiographic finding
Rachel L Choit1, Douglas H Jamieson, Christopher W Reilly
1Department of Orthopaedics, BC Children's Hospital, A234-4480 Oak St., Vancouver, BC, Canada, V6H 3V4.
Pediatric Radiology
|May 3, 2005
Summary
Os odontoideum, an anomaly of the C2 vertebra, can cause atlantoaxial joint instability. Early detection in pediatric cervical spine imaging is crucial for preventing spinal cord injury.
Area of Science:
- Orthopedics
- Pediatric Radiology
- Neurosurgery
Background:
- Os odontoideum is a rare congenital anomaly involving the odontoid process (dens) of the C2 vertebra.
- It can lead to atlantoaxial instability, increasing the risk of spinal cord injury, especially after trauma.
- Early diagnosis is critical for management and preventing severe neurological deficits.
Observation:
- Two pediatric cases of os odontoideum are presented.
- The anomaly was retrospectively identified on prior imaging in both patients.
- One patient experienced an acute spinal cord injury secondary to os odontoideum.
Findings:
- Os odontoideum can be subtle and missed on initial pediatric cervical spine imaging.
- The instability associated with os odontoideum poses a significant risk for catastrophic spinal cord events.
- Prompt identification allows for timely intervention and management.
Implications:
- Integrating dens integrity assessment into pediatric cervical spine imaging protocols can improve early detection rates.
- Early detection facilitates referral to specialized spinal services for surveillance and potential surgical intervention.
- Proactive management of os odontoideum can prevent long-term complications and improve patient outcomes.