Paraskevas George K, Raikos Athanasios, Martoglou Smaro, Ioannidis Orestis
Department of Anatomy, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
J Radiol Case Rep. 2011;5(8):22-9. doi: 10.3941/jrcr.v5i8.708. Epub 2011 Aug 1.
Sesamoid ossicles are ovoid or round nodular small bones found usually within a joint or tendon of the upper and lower limb and rarely at other regions. They are usually asymptomatic, resulting in an increased propensity to injuries. We report on two cases where sesamoid ossicles were detected within the nuchal ligament. The first one was a 55-years-old Caucasian male office employee, complaining of chronic pain in the cervical spine region accompanied by numbness of the left upper limb. During the routine lateral X-ray imaging two sesamoid ossicles were found within the nuchal ligament at the C4 and C5 spinous processes level. The second case was a 64-years-old Caucasian female store employee, complaining of chronic cervical spine pain. The routine lateral X-ray exhibited two sesamoid ossicles within the nuchal ligament at the C5 and C6 spinous processes level. Sesamoid ossicles found in the nuchal ligament in rare cases may become symptomatic and the pathogenesis mechanism should be differentially diagnosed by the physician. We discuss the precise morphology of the trait, the possible etiological mechanisms for their appearance, the histological features, as well as differential diagnosis.
籽骨是卵圆形或圆形的小结节状小骨，通常见于上肢和下肢的关节或肌腱内，很少见于其他部位。它们通常无症状，因而受伤的倾向增加。我们报告两例在项韧带内检测到籽骨的病例。第一例是一名55岁的白人男性办公室职员，主诉颈椎区域慢性疼痛并伴有左上肢麻木。在常规颈椎侧位X线成像检查中，于C4和C5棘突水平的项韧带内发现两枚籽骨。第二例是一名64岁的白人女性商店雇员，主诉颈椎慢性疼痛。常规颈椎侧位X线片显示在C5和C6棘突水平的项韧带内有两枚籽骨。罕见情况下在项韧带中发现的籽骨可能会出现症状，医生应鉴别诊断其发病机制。我们讨论了该特征的确切形态、其出现的可能病因机制、组织学特征以及鉴别诊断。
