Os Odontoideum Mimicking Acute Odontoid Peg Fracture
Bibliographic record
Abstract
The atlantoaxial complex is a common site for cervical spine injuries, of which fractures of the axis (C2), occur most frequently. Over half of these fractures involve the odontoid process. Numerous developmental anomalies of the axis, although rare, can also occur and may simulate trauma. Specifically, os odontoideum is a cranial-vertebral junction anomaly in which the odontoid remains separate from the body of the axis as an independent ossicle. We report a case of a 53-year-old incarcerated male who was found by his five cellmates hanging partially suspended by a bed sheet. Emergency personnel re-established a pulse for a short time, and the patient was transferred to the hospital. Imaging of the cervical spine pointed to an avulsion fracture of the odontoid process of the axis, raising the possibility of trauma and foul play. Postmortem lateral radiographs revealed a smooth ossicle with a circumferential cortical rim superior to the axis, and a posterior neck dissection failed to reveal evidence of an acute injury. Contrary to the diagnosis of an isolated odontoid fracture, this is a case of os odontoideum. This case emphasizes the importance of a thorough dissection with direct visualization, accompanied by a complete investigation and radiographs. An overview of the development of the axis is discussed, including descriptions of various anomalies of the odontoid that may be encountered during postmortem cervical spine examination. Failure of the forensic pathologist to recognize the developmental anomalies of the axis could lead to improper certification of death, resulting in devastating medicolegal consequences.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.004 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".