To discuss the normal and the variant anatomy involving the CVJ region and the various craniometric measurements used for the radiologic assessment of region.
To discuss various congenital and acquired anomalies involving CVJ.
Radiological workup of the craniovertebral anomalies.
Anatomy of CVJ:
Articular anatomy: upper surfaces of C1 lateral masses are cup like or concave which fit in to the ball and socket configuration,
united by articular capsules surrounding the atlanto-occipital joint & by anterior & posterior atlanto-occipital membranes.
Atlas and axis- four synovial joints between atlas and axis
two median- front and back of dens (pivot variety)
two lateral-between opposing articular facets(plane variety),
rotation is up to 900 and approximately half occurs at A-A joint
Ligamentous anatomy: principal stabilising ligaments of C1(figure.1)
Findings and procedure details
Evaluation and assessment of CVJ anomalies is challenging and coming to accurate diagnosis plays a crucial role in the management.
developmental and acquired anomalies cause atlanto-axial instability or it can affect the vertebra basilar vascular system.
The various causes are broadly classified into
Malformation of the occipital bone
Remanants around foramen magnum
Dens segmentation anomalies
Assimilation of atlas
AsMalformations of atlas
Asimilation of atlas
Atlanto axial fusion
Aplasia of atlas arch
Malformation of axis
The CVJ is a common site for anatomic variants and acquired pathology.
Understanding of the important land marks and accurate assessment of the lines and angles is crucial in the evaluation of craniovertebral junction anomalies
Knowledge of the normal anatomy as well as the spectrum of bony variants,
acquired anomalies of this region is vital for the diagnosis and correct image interpretation and ulterior management.
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