Published in:
01-09-2009 | Case Report
Clival osteomyelitis resulting from spread of infection through the fossa navicularis magna in a child
Authors:
Sanjay P. Prabhu, Timothy Zinkus, Alan G. Cheng, Reza Rahbar
Published in:
Pediatric Radiology
|
Issue 9/2009
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Abstract
The fossa navicularis is a notch-like bone defect in the basiocciput that has been hitherto considered as an anatomical variant of the clivus and not previously described as a potential source of clival or skull base pathology. We report the imaging findings in a 5-year-old child who presented acutely with a retropharyngeal abscess and osteomyelitis of the clivus. Imaging after treatment revealed a “notch-like” defect in the anterior clivus consistent with a fossa navicularis. Based on these appearances, we postulate that the lymphoid tissue of the pharyngeal tonsil residing in the fossa navicularis served as a route through which infection spread and subsequently developed into clival osteomyelitis, which is a rare diagnosis. This case is unique, and we believe that the presence of this variant in young children may be important and is not merely an anatomical curiosity.