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<meta name="DC.Title" content="Normal Ossification Patterns of Atlas and Axis: A CT Study" />
<meta name="DC.Identifier" content="10.3174/ajnr.A3105" />
<meta name="DC.Date" content="2012-11-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Development of the CVJ is a complex process rarely analyzed by CT. Cartilaginous remnants within the atlas and axis have been shown to variably persist throughout childhood and may be mistaken for fractures. The purpose of this study was to better estimate the fusion timeline of the synchondroses at the CVJ.

MATERIALS AND METHODS: We retrospectively reviewed singular CT scans in 550 children without known skeletal dysplasia or maturation delay (from neonate to 17 years) and analyzed the ossification of atlas and axis. Normal closing age for synchondroses was defined as soon as a complete ossification rate of 80% or more per age category was achieved.

RESULTS: No separate OC was observed in 38 of 230 incompletely ossified AAAs, whereas single, bipartite, or multiple OCs were observed in, respectively, 196, 86, and 16 of 298 AAAs in which OCs could be identified. Synchondroses at the AAA closed after 12 years (range 4.5–17 years). Posterior midline synchondrosis of the atlas closed after 4 years (range 2–13 years). The axis ossified from 6 OCs and 4 synchondroses. Subdental and neurocentral synchondroses closed simultaneously after 9 years (range 7–9.5 years). Apicodental synchondrosis and chondrum terminale were completely ossified after 10.5 years (range 5.5–13.5 years).

CONCLUSIONS: Analysis of the CVJ using triplanar CT reconstructions allows secure identification of characteristic developmental features of the atlas and axis, and helps to separate normal variants from true osseous lesions.

AAA
:   anterior atlas arch
ADS
:   apicodental synchondrosis
CHT
:   chondrum terminale
CVJ
:   craniocervical junction
OC
:   ossification center
PAA
:   posterior atlas arch
SDS
:   subdental synchondrosis" />
<meta name="DC.Contributor" content="G.M. Karwacki" />
<meta name="DC.Contributor" content="J.F. Schneider" />
<meta name="article:published_time" content="2012-11-01" />
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<meta name="citation_title" content="Normal Ossification Patterns of Atlas and Axis: A CT Study" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Development of the CVJ is a complex process rarely analyzed by CT. Cartilaginous remnants within the atlas and axis have been shown to variably persist throughout childhood and may be mistaken for fractures. The purpose of this study was to better estimate the fusion timeline of the synchondroses at the CVJ.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;We retrospectively reviewed singular CT scans in 550 children without known skeletal dysplasia or maturation delay (from neonate to 17 years) and analyzed the ossification of atlas and axis. Normal closing age for synchondroses was defined as soon as a complete ossification rate of 80% or more per age category was achieved.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;No separate OC was observed in 38 of 230 incompletely ossified AAAs, whereas single, bipartite, or multiple OCs were observed in, respectively, 196, 86, and 16 of 298 AAAs in which OCs could be identified. Synchondroses at the AAA closed after 12 years (range 4.5–17 years). Posterior midline synchondrosis of the atlas closed after 4 years (range 2–13 years). The axis ossified from 6 OCs and 4 synchondroses. Subdental and neurocentral synchondroses closed simultaneously after 9 years (range 7–9.5 years). Apicodental synchondrosis and chondrum terminale were completely ossified after 10.5 years (range 5.5–13.5 years).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Analysis of the CVJ using triplanar CT reconstructions allows secure identification of characteristic developmental features of the atlas and axis, and helps to separate normal variants from true osseous lesions.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="twitter:title" content="Normal Ossification Patterns of Atlas and Axis: A CT Study" />
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<meta name="twitter:image" content="http://ajnr-stage2.stage.highwire.org/sites/default/files/highwire/ajnr/33/10.cover-source.jpg" />
<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Development of the CVJ is a complex process rarely analyzed by CT. Cartilaginous remnants within the atlas and axis have been shown to variably persist throughout childhood and may be mistaken for fractures. The purpose of this study was to better estimate the fusion timeline of the synchondroses at the CVJ.

MATERIALS AND METHODS: We retrospectively reviewed singular CT scans in 550 children without known skeletal dysplasia or maturation delay (from neonate to 17 years) and analyzed the ossification of atlas and axis. Normal closing age for synchondroses was defined as soon as a complete ossification rate of 80% or more per age category was achieved.

RESULTS: No separate OC was observed in 38 of 230 incompletely ossified AAAs, whereas single, bipartite, or multiple OCs were observed in, respectively, 196, 86, and 16 of 298 AAAs in which OCs could be identified. Synchondroses at the AAA closed after 12 years (range 4.5–17 years). Posterior midline synchondrosis of the atlas closed after 4 years (range 2–13 years). The axis ossified from 6 OCs and 4 synchondroses. Subdental and neurocentral synchondroses closed simultaneously after 9 years (range 7–9.5 years). Apicodental synchondrosis and chondrum terminale were completely ossified after 10.5 years (range 5.5–13.5 years).

CONCLUSIONS: Analysis of the CVJ using triplanar CT reconstructions allows secure identification of characteristic developmental features of the atlas and axis, and helps to separate normal variants from true osseous lesions.

AAA
:   anterior atlas arch
ADS
:   apicodental synchondrosis
CHT
:   chondrum terminale
CVJ
:   craniocervical junction
OC
:   ossification center
PAA
:   posterior atlas arch
SDS
:   subdental synchondrosis" />
<meta name="og-title" property="og:title" content="Normal Ossification Patterns of Atlas and Axis: A CT Study" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/33/10/1882" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Development of the CVJ is a complex process rarely analyzed by CT. Cartilaginous remnants within the atlas and axis have been shown to variably persist throughout childhood and may be mistaken for fractures. The purpose of this study was to better estimate the fusion timeline of the synchondroses at the CVJ.

MATERIALS AND METHODS: We retrospectively reviewed singular CT scans in 550 children without known skeletal dysplasia or maturation delay (from neonate to 17 years) and analyzed the ossification of atlas and axis. Normal closing age for synchondroses was defined as soon as a complete ossification rate of 80% or more per age category was achieved.

RESULTS: No separate OC was observed in 38 of 230 incompletely ossified AAAs, whereas single, bipartite, or multiple OCs were observed in, respectively, 196, 86, and 16 of 298 AAAs in which OCs could be identified. Synchondroses at the AAA closed after 12 years (range 4.5–17 years). Posterior midline synchondrosis of the atlas closed after 4 years (range 2–13 years). The axis ossified from 6 OCs and 4 synchondroses. Subdental and neurocentral synchondroses closed simultaneously after 9 years (range 7–9.5 years). Apicodental synchondrosis and chondrum terminale were completely ossified after 10.5 years (range 5.5–13.5 years).

CONCLUSIONS: Analysis of the CVJ using triplanar CT reconstructions allows secure identification of characteristic developmental features of the atlas and axis, and helps to separate normal variants from true osseous lesions.

AAA
:   anterior atlas arch
ADS
:   apicodental synchondrosis
CHT
:   chondrum terminale
CVJ
:   craniocervical junction
OC
:   ossification center
PAA
:   posterior atlas arch
SDS
:   subdental synchondrosis" />
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      <h1 class="highwire-cite-title" id="page-title">Normal Ossification Patterns of Atlas and Axis: A CT Study</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">G.M. Karwacki</span> and <span class="highwire-citation-author" data-delta="1">J.F. Schneider</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">November 2012,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">33 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1882-1887; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A3105 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-12110--6193298486" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">G.M. Karwacki </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology (G.M.K.)</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Pediatric Radiology (G.M.K., J.F.S.), University Hospital Basel, Basel, Switzerland.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=G.M.%2BKarwacki%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Karwacki%20G&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AG.M.%2BKarwacki%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">J.F. Schneider </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Pediatric Radiology (G.M.K., J.F.S.), University Hospital Basel, Basel, Switzerland.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.F.%2BSchneider%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Schneider%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AJ.F.%2BSchneider%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div></div></div>  </div>

  
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<p id="p-2"><strong>BACKGROUND AND PURPOSE:</strong> Development of the CVJ is a complex process rarely analyzed by CT. Cartilaginous remnants within the atlas and axis have been shown to variably persist throughout childhood and may be mistaken for fractures. The purpose of this study was to better estimate the fusion timeline of the synchondroses at the CVJ.</p>
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<p id="p-3"><strong>MATERIALS AND METHODS:</strong> We retrospectively reviewed singular CT scans in 550 children without known skeletal dysplasia or maturation delay (from neonate to 17 years) and analyzed the ossification of atlas and axis. Normal closing age for synchondroses was defined as soon as a complete ossification rate of 80% or more per age category was achieved.</p>
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<p id="p-4"><strong>RESULTS:</strong> No separate OC was observed in 38 of 230 incompletely ossified AAAs, whereas single, bipartite, or multiple OCs were observed in, respectively, 196, 86, and 16 of 298 AAAs in which OCs could be identified. Synchondroses at the AAA closed after 12 years (range 4.5–17 years). Posterior midline synchondrosis of the atlas closed after 4 years (range 2–13 years). The axis ossified from 6 OCs and 4 synchondroses. Subdental and neurocentral synchondroses closed simultaneously after 9 years (range 7–9.5 years). Apicodental synchondrosis and chondrum terminale were completely ossified after 10.5 years (range 5.5–13.5 years).</p>
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<p id="p-5"><strong>CONCLUSIONS:</strong> Analysis of the CVJ using triplanar CT reconstructions allows secure identification of characteristic developmental features of the atlas and axis, and helps to separate normal variants from true osseous lesions.</p>
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</div><div class="section glossary" id="glossary-1">
<h2>ABBREVIATIONS:</h2>
<dl id="def-list-1"><dt id="def-item-1">AAA<span class="def-item-dt-sep"></span></dt><dd>anterior atlas arch<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">ADS<span class="def-item-dt-sep"></span></dt><dd>apicodental synchondrosis<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">CHT<span class="def-item-dt-sep"></span></dt><dd>chondrum terminale<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">CVJ<span class="def-item-dt-sep"></span></dt><dd>craniocervical junction<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">OC<span class="def-item-dt-sep"></span></dt><dd>ossification center<span class="def-item-dd-sep"></span></dd><dt id="def-item-6">PAA<span class="def-item-dt-sep"></span></dt><dd>posterior atlas arch<span class="def-item-dd-sep"></span></dd><dt id="def-item-7">SDS<span class="def-item-dt-sep"></span></dt><dd>subdental synchondrosis</dd></dl>
</div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2012 by American Journal of Neuroradiology</li></ul><div class="license" id="license-1"><p id="p-1">Indicates open access to non-subscribers at <a href="http://www.ajnr.org">www.ajnr.org</a></p></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/33/10/1882.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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      <div class="highwire-cite-title">Normal Ossification Patterns of Atlas and Axis: A CT Study</div>  
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