title: Varied clinical presentation of os odontoideum: a case report.
abstract: OBJECTIVE
  To present a case of an os odontoideum and to provide insight into the varied clinical presentations.
  
  
  METHODS
  A 54 year old man presented with chronic neck pain without headache. A clinical examination was performed and the chiropractor viewed his AP and lateral radiographs. Previous flexion/ extension radiographs and MRI imaging from 2009 were requested for review. The patient was diagnosed with grade II mechanical neck pain. Treatment was rendered that day which included spinal manipulation/ mobilization. Several days later the requested imaging reports were received and described the presence of an os odontoideum.
  
  
  CONCLUSIONS
  In the presence of os odontoideum, familiarity with the signs and symptoms of potential cervical instability is imperative. Health care providers must remain diligent in their patient histories, physical exams, and imaging. This case highlights the importance of following up on imaging studies to rule out diagnoses that would involve treatment contraindications thus ensuring safe and effective treatment.
authors.affiliation: Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Canada ; Division of Graduate Studies, Clinical Sciences, Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Ontario, Canada.
authors.forename: Karen
authors.initials: K
authors.lastname: Chrobak
authors.affiliation: Private Practice, 537 Frederick St, Kitchener Ontario Canada.
authors.forename: Ryan
authors.initials: R
authors.lastname: Larson
authors.affiliation: Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Canada ; Director, Graduate Education, Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Ontario, Canada.
authors.forename: Paula J
authors.initials: PJ
authors.lastname: Stern
keywords: cervical anomaly; chiropractic; instability; neck pain; os odontoideum