title: Dimensions of the craniocervical junction in longitudinal analysis of normal growth.
abstract: BACKGROUND
  Abnormal configuration of the craniocervical junction in the form of basilar impression or invagination, with often-associated platybasia, is a clinically significant cause of neurological symptoms particularly in patients with inherited diseases affecting the connective tissue. To better understand the course of development of these basilar abnormalities and further define their diagnostic criteria in children, we analysed longitudinally changes in the vertical dimensions of the craniocervical junction and in the flexion of the anterior skull base in normal growing individuals.
  
  
  METHODS
  The distance of the odontoid process to four reference lines and the anterior skull base angle was measured in consecutive series of at least five lateral skull radiographs of 30 females and 23 males. Their mean age was 6.4 years at the beginning and 22.4 years at the end of the observation period.
  
  
  RESULTS
  In young children, the odontoid process was situated in a caudal relation to the skull base structures and reached a level similar to that of adults approximately at the age of 7 years in both males and females. Cross-sectional observation of the results camouflages, however, how the intra-individual changes were markedly non-linear. Changes in the anterior skull base angle remained nonsignificant.
  
  
  CONCLUSIONS
  Normal values for McRae's, Chamberlain's and McGregor's measurements and the more recently documented D-M measurement are age dependent. We provide reference values specific for ages from 4 years. A notable deviation from the documented values indicates a need of further examination.
authors.affiliation: Department of Orthodontics, Institute of Dentistry, University of Helsinki, P.O. Box 41, 00014, Helsinki, Finland. heidi.arponen@fimnet.fi
authors.forename: Heidi
authors.initials: H
authors.lastname: Arponen
authors.forename: Marjut
authors.initials: M
authors.lastname: Evälahti
authors.forename: Janna
authors.initials: J
authors.lastname: Waltimo-Sirén
mesh_terms: D000293:Adolescent; D000328:Adult; D000375:Aging; D002574:Cervical Vertebrae / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000254:growth & development*; D002648:Child; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011859:Radiography; D012727:Sex Characteristics; D012886:Skull / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000254:growth & development*; D055815:Young Adult