Question 1819
{"accessible":true,"alternatives":[{"id":9035,"text":"accessory ossicle of the anterior arch"},{"id":9036,"text":"anterior aspect of the lateral mass of C2"},{"id":9037,"text":"calcium pyrophosphate deposition"},{"id":9038,"text":"ear lobe"},{"id":9039,"text":"longus colli calcific tendinitis "}],"archived":false,"correctAlternativeId":9038,"explanation":"\u003cp\u003eIt is not uncommon for the outline of the ear lobes to project over this region on a lateral image and to simulate \u003ca href=\"/articles/calcific-tendinitis-of-the-longus-colli-muscle-2\" title=\"Calcific tendinitis of the longus colli muscle\"\u003elongus colli calcific tendinosis\u003c/a\u003e. In this case the second ear lobe can be seen projecting slightly more posteriorly making the distinction relatively easy.\u003c/p\u003e\u003cp\u003eAn \u003ca href=\"/articles/accessory-ossicle-of-the-anterior-arch-of-the-atlas-1\" title=\"Accessory ossicle of the anterior arch of the atlas\"\u003eaccessory ossicle of the anterior arch\u003c/a\u003e would be expected to be a smaller density than\u0026nbsp;this and to have a corticated margin.\u0026nbsp;\u003c/p\u003e\u003cp\u003eThe anterior aspect of the lateral mass of C2 often projects slightly in front of the dens on a lateral radiograph however it can be traced and seen not to account for the density in this case.\u0026nbsp;\u003c/p\u003e\u003cp\u003eWhile\u0026nbsp;\u003ca href=\"/articles/calcium-pyrophosphate-dihydrate-deposition-disease-1\" title=\"Calcium pyrophosphate deposition disease (CPPD)\"\u003ecalcium pyrophosphate deposition\u003c/a\u003e\u0026nbsp;can occur around the dens, this tends to occur in older patients and creates a speckled appearance at the top and posterior to the dens rather than anterior to it (\u003ca href=\"/articles/crowned-dens-syndrome\" title=\"Crowned dens syndrome\"\u003ecrowned dens\u003c/a\u003e).\u003c/p\u003e","id":1819,"imageUrl":"https://prod-images-static.radiopaedia.org/multiple_choice_questions/304/density.001_big_gallery.jpeg","imageAttribution":{"kind":"external","attribution":"Contributed by Matt Skalski"},"imageAttributionCaseInfo":null,"firstQuestionPath":"/questions/1819","nextQuestionPath":null,"relatedArticles":[{"id":7003,"title":"Calcific tendinitis of the longus colli muscle","link":"/articles/calcific-tendinitis-of-the-longus-colli-muscle-2?lang=us"},{"id":42981,"title":"Crowned dens syndrome","link":"/articles/crowned-dens-syndrome?lang=us"},{"id":1037,"title":"Calcium pyrophosphate dihydrate deposition disease","link":"/articles/calcium-pyrophosphate-dihydrate-deposition-disease-1?lang=us"}],"alsoUsedIn":[{"id":804,"kind":"Course","title":"X-ray Interpretation: Cervical Spine - page 804","link":"https://radiopaedia.org/courses/x-ray-interpretation-cervical-spine/pages/804"},{"id":804,"kind":"Course","title":"Emergency Radiology Course - Melbourne - page 804","link":"https://radiopaedia.org/courses/emergency-radiology-course-melbourne-2022/pages/804"},{"id":804,"kind":"Course","title":"Emergency Radiology Course - Brisbane - page 804","link":"https://radiopaedia.org/courses/emergency-radiology-course-brisbane-2022/pages/804"}],"stem":"\u003cp\u003eLateral cervical radiograph in a young adult with neck pain. Which of the following best accounts for\u0026nbsp;the arrowed\u0026nbsp;density seen below the anterior arch of C1?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/1819"}],"attemptsPercentages":[{"alternativeId":"9038","percentage":78},{"alternativeId":"9039","percentage":11},{"alternativeId":"9036","percentage":2},{"alternativeId":"9035","percentage":4},{"alternativeId":"9037","percentage":6}],"promptToLogin":false,"questionManager":false,"articleId":"accessory-ossicle-of-the-anterior-arch-of-the-atlas"}