Sesamoid Bones in the Soft Tissue of Neck as Incidental Finding on Multidetector Computed Tomography

Abstract

Sesamoid ossicles are round to oval small bones, usually seen in relation to tendon of a muscle or a joint with less frequent occurrence at other locations. They are asymptomatic in the vast majority of cases; however, predispose to increased risk of injury. In a few other cases, they may present as a palpable mass accompanied by vague neck pain or stiffness. Rarely, these bony structures can be seen in close relation to ligamentum nuchae or paraspinal muscles and may predispose to pain in the neck. They are known to be stable in size over time and show no evidence of recurrence after surgical excision. Histologically, they are considered fibrocartilagenous tumour formed secondary to fibrocartilagenous metaplasia triggered by localised repetitive trauma or chronic mechanical stress. We report two cases where sesamoid ossicles were detected within the nuchal ligament. Only few cases of this entity lesion have been reported previously.

Keywords

• ligamentum nuchae
• ossicle
• paraspinal