Odontoid Peg

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  • ascension of the atlas fused to the ascension of the axis
  • articular facet at front
    • forms non-weightbearing joint with arch of atlas
  • Connected to the occiput by the alar ligaments and apical ligaments
    • from sloping upper edge to foramen magnum
    • inner ligaments limit rotation of head, v. strong
    • weak apical ligament joins apex of peg to anterior margin of foramen magnum
      • remnant of notochord 
      • lies in front of upper longitudinal bone of cruciform ligament
  • seen on 'open mouth' X-rays
  • fracture causes retropharyngeal haematoma
 

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