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Figure 1: Sagittal reformat (a) of noncontrast cervical CT shows a cleft in the basal odontoid (blue arrow) suggestive of a midline integration defect with persistent ossiculum terminale (white arrow). Note hypertrophied anterior arch of atlas (yellow arrow). Coronal reformat (b, c) of the same shows persistent ossiculum terminale (white arrow in b and c) with midline integration defect of the basal odontoid (black arrow in b). Lateral cervical radiograph in flexion (d) shows anterior displacement of the anterior arch of atlas and ossiculum terminale (arrow) relative to the position in extension (arrow in e) and neutral position (arrow in f)

Figure 1: Sagittal reformat (a) of noncontrast cervical CT shows a cleft in the basal odontoid (blue arrow) suggestive of a midline integration defect with persistent ossiculum terminale (white arrow). Note hypertrophied anterior arch of atlas (yellow arrow). Coronal reformat (b, c) of the same shows persistent ossiculum terminale (white arrow in b and c) with midline integration defect of the basal odontoid (black arrow in b). Lateral cervical radiograph in flexion (d) shows anterior displacement of the anterior arch of atlas and ossiculum terminale (arrow) relative to the position in extension (arrow in e) and neutral position (arrow in f)