A large ossicle occasionally seen along the inferior surface of the anterior arch of C1 should not to be mistaken for a fracture. Keats has named this the
inferior accessory ossicle of the anterior arch of the atlas. On the lateral view of radiographs and on sagittal CT or MR images, it appears as a triangle with its base along the undersurface of the anterior arch of C1. On coronal reformations, however, we see that it has more of a diamond shape.
References
Keats TE. The inferior accessory ossicle of the anterior arch of the atlas. Am J Roentgenol Radium Ther Nucl Med. 1967 Dec;101(4):834-6.
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