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Skeletal Radiol. 2019 Oct;48(10):1511-1523. doi: 10.1007/s00256-019-03187-z. Epub 2019 Mar 13.

Thinking beyond pannus: a review of retro-odontoid pseudotumor due to rheumatoid and non-rheumatoid etiologies.

Author information

1
Department of Radiology, Division of Musculoskeletal Imaging and Intervention, Brigham and Women's Hospital, 75 Francis St., Boston, MA, 02115, USA. jshi9@bwh.harvard.edu.
2
Harvard Medical School, Boston, MA, 02115, USA. jshi9@bwh.harvard.edu.
3
Division of Rheumatology, Immunology and Allergy, Department of Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA.
4
Department of Radiology, Division of Musculoskeletal Imaging and Intervention, Brigham and Women's Hospital, 75 Francis St., Boston, MA, 02115, USA.
5
Harvard Medical School, Boston, MA, 02115, USA.

Abstract

Retro-odontoid pseudotumor, or mass-like retro-odontoid soft tissue thickening, is an uncommon but important imaging finding that may be associated with rheumatoid arthritis, crystal deposition diseases, as well as non-inflammatory conditions such as cervical degenerative changes and mechanical alterations. Retro-odontoid pseudotumor is commonly associated with atlantoaxial microinstability or subluxation. MRI and CT have an important role in the detection and diagnosis of retro-odontoid pseudotumor. However, due to a wide range of imaging characteristics and ambiguous etiology, it is a frequently misunderstood entity. The purpose of this article is to review relevant anatomy of the craniocervical junction; describe various imaging appearances, pathophysiology and histology in both rheumatoid and non-rheumatoid etiologies; and discuss differential diagnosis of retro-odontoid pseudotumor in order to help guide clinical management.

KEYWORDS:

Atlantoaxial; Cervical spine; Odontoid; Pannus; Retro-odontoid pseudotumor; Rheumatoid arthritis

PMID:
30868232
DOI:
10.1007/s00256-019-03187-z

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