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Updated: Aug 7, 2026

Systematic Assessment of Mammalian Skull Specimens for Dental and Temporomandibular Joint Pathology
Published on: August 22, 2022
The median atlanto-occipital joint in advanced age
Michael Von Lüdinghausen1, Andreas Prescher, Ikuo Kageya
1Institute of Anatomy and Cell Biology, University of Würzburg, Würzburg, Germany. anat033@mail.uni-wuerzburg.de
Study Design:
Exploration of the craniocervical junction in cadavers of elderly individuals.
Objective:
Histologic evaluation of osseous contact zones observed between the basiocciput and anterior arch of the atlas.
Summary Of Background Data:
Previous findings of possible osseous contact zones at the anterior rim of the foramen magnum and anterior arch of the atlas suggested the existence of real joints.
Methods:
A total of 100 cadaver specimens were investigated using magnetic resonance imaging, computerized tomography, and median saw-cut and histologic sections.
Results:
Of the specimens, 42% showed osteoarthritis-related osteophytes (primarily directed cranially) of the articular surfaces of the median atlantoaxial joint. In 5 cases, a large osteophyte of the anterior arch of the atlas touched the basiocciput. In 3 cases, a third occipital condyle touched the anterior arch of the atlas and/or tip of the dens. These osseous contact zones were histologically verified as real joints (the median atlanto-occipital or occipito-odontoid joints).
Conclusions:
Of the 8 median atlanto-occipital joints found in this study, 3 were third occipital-condyle based, and 5 osteoarthritis-based. The former were congenital in character, while the latter were acquired.
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