Learning objectives
To describe normal anatomy of craniocervical junction (CCJ) and to evaluate main non-traumatic diseases of this anatomical region through imaging: X-ray (XR),
computed tomography (CT) and magnetic risonance imaging (MRI).
Background
CCJ refers to an anatomical region formed by the occipital bone,
the foramen magnum,
the clivus,
the atlas and the support ligaments of atlanto-occipital and atlanto-axial joints that allow movements of flexion,
extension,
lateral inclination and horizontal rotation of the head [1-2].(Fig. 1)Anatomical relevance of this region is due both to its wide mobility and to the nervous structures that pass through it.
To know its main radiological findings is essential to help the clinician understand the role of imaging in the diagnosis and treatment...
Findings and procedure details
The anomalies of CCJ can be divided into congenital and acquired pathologies.
In order to evaluate the main abnormalities it is important to know the main craniometric lines: Waikenheim line (drawn parallel to the superior surface of the clivusand extending inferiorly to the upper cervical canal; the tip of the dens should be ventral and tangential to this line); Chamberlain line (it goes from the back edge of the palatine process of the hard palate to the posterior midpoint of the large occipital foramen); McRae...
Conclusion
The CCJ represents a complex area of multidisciplinary interest.
The radiologist should be familiar with is anatomy and aware of its possible diseases and respective radiological findings.
The combined use of XR,
CT and MRI allows to identify and characterize the pathologies of this region with accuracy.
A in-depth knowledge of craniometric lines and anatomical landmarks allows a correct diagnosis and subsequent a timely management of these pathologies,
often underestimated and/or misunderstood.
Personal information
Alfredo Gaetano Torcitto,
MD,
Department of Medical and Surgical Sciences and Advanced Technologies"G.
F.
Ingrassia" – Radiology I Unit,
University Hospital “Policlinico-Vittorio Emanuele”,
Via Santa Sofia 78,
Catania,
95123,
Italy;
[email protected]
Maria Carla Calcagno,
MD,Department of Medical and Surgical Sciences and Advanced Technologies"G.
F.
Ingrassia" – Radiology I Unit,
University Hospital “Policlinico-Vittorio Emanuele”,
Via Santa Sofia 78,
Catania,
95123,
Italy;
[email protected]
Maria Josè Anzalone,
MD,Department of Medical and Surgical Sciences and Advanced Technologies"G.
F.
Ingrassia" – Radiology I Unit,
University Hospital “Policlinico-Vittorio Emanuele”,
Via Santa...
References
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Kavitha,
Abdul Gafoor,
Suresh B,
Harinath,
Padmalatha.
Radiological evaluetion of craniovertebral junction anomalies.
Journal of evidence based medicine and healthcare 2015 Aug; 35.
2 - Ramen Talukdar ,
Rajkumar S Yalawar,
Mohan Kumar.
Imaging In Craniovertebral Junction (CVJ) Abnormalities.
Journal of Dental and Medical Sciences 2015 Dec Vol 14,
Issue 12.
3 - Riascos R,
Bonfante E,
Cotes C,
Guirguis M,
Hakimelahi R,
West C.
Imaging of Atlanto-Occipital and Atlantoaxial Traumatic Injuries: What the Radiologist Needs to Know.
Radiographics.
2015...