Occipital spurs, also known as occipital knobs, occipital buns, chignon hooks or inion hooks, are anatomical variants that represent an exaggerated external occipital protuberance 1.
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Epidemiology
It is common in males and hence is often used in forensic investigations for gender determination 1.
Clinical presentation
It is an anatomical variant which is usually noticed incidentally radiographically, although it can become symptomatic with affected patients describing a tender bony swelling at the back of the neck causing pain especially while lying down 1.
Pathology
Three types have been described:
- type I: smooth type
- type II: crest type
- type III: spine type
Radiographic features
Dimensions of the occipital spur are measured as width at its base and standing height above the normal outline of occipital bone.
Treatment and prognosis
Soft pillows and analgesia are usually trialed before surgery and may be effective. However, in patients whose symptoms fail conservative management, surgical excision and smoothening of the bone leads to adequate recontouring and relieves the symptoms 1.
Differential diagnosis
On imaging consider
- osteoma
- skull metastasis
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