Lecture 1: Normal variants

Question 1

What is a Posterior ponticle?

Answer 1

Calcification of occipito-atlantal ligament creates an opening called the arcuate foramen, large risk for VBI on rotatory manipulation. Vertebral artery and 1st cervical nerve pass through it

Question 2

What is this

Answer 2

Posterior ponticle

Question 3

What is this?

Answer 3

Pseudo jefferson fracture

Appear as overhanging edges of C1 lateral masses. In adult this would suggest a Jefferson # (bursting # to ring of atlas) however in children represents differential ossification rate between C1 & 2.

Question 4

What is a limbic bone?

Answer 4

Ossicles at anterior corners of V.B. Bone is produced as a result of migration and herniation of nuclear material through the secondary growth centre for the corner of the V.B. results in non-union of secondary growth centre.

Question 5

What is fabella?

Answer 5

Normal sesamoid bone within the lateral gastroc tendon.

Question 6

What is this?

Answer 6

Limbic bone

Question 7

What are normal variants?

Answer 7

Anormalities in Ossification

2 classifications:

• Calcification / ossification of soft tissue:
  
  • Most common in the skull and spine
  • Calcification of falx cerebri, choroid plexus, pineal gland etc.
• Incomplete mineralisation of bone
  
  • Patent metopic suture (10% pop.)
  • Bipartate / tripartate patella

Question 8

What is this normal variant?

Answer 8

Talar beak

Developmental variance that should not be confused with spurring.

Question 9

What is this normal variant?

Answer 9

Excessive external occipital protuberance

Question 10

What is this normal variant?

Answer 10

Os - trigonum

An accessory ossicle and should not be confused with # of post. Process of talus.

Question 11

What is this normal variant

Answer 11

Normal Ischial apophysis/growth centre