The Skull
Skull, Biplane Views
The calvaria is normal in shape, thickness, and size. There are no abnormalities of mineralization or bone structure. The contours of the calvaria are smooth and sharp with no abnormal defects or discontinuities. The cranial sutures appear normal for age. There is no sign of abnormal calcifications.
The skull base presents a normal anatomical configuration and smooth borders, with a normal appearance of the planum sphenoidale, sella turcica, and posterior cranial fossa. Imaged portions of the facial skeleton and upper cervical spine are normally developed and have smooth, sharp contours. Evaluable portions of the paranasal sinuses are unremarkable.
Imaged soft tissues show no abnormalities.
Interpretation
The skull appears normal.
Checklist
| Shape, size | • | Approximately hemispherical |
| Thickness | • | Normal bone thickness (see below) |
| • | Three layers (inner table, diploë, outer table) |
| Structure | • | Mineralization |
| • | No circumscribed densities (sharp or indistinct, cloudy, striate, patchy) |
| • | No circumscribed areas of decalcification or erosion (rounded, oblong, with sclerosis? fracture lines? sharp or indistinct?) |
| • | Convolutional markings regular, not increased |
| Vascular channels | • | Arteries, diploic veins, emissary veins: course, shape, thickness, caliber, location |
| Contours | • | Outer and inner tables are smooth and sharp |
| • | No defects or discontinuities |
| • | No spicules or excrescences |
| sutures | • | Open or closed? (see below) |
| Cranial cavity | • | Calcifications? (If so: location—e.g., pineal body: centered, not displaced) |
| Skull base | • | Normal configuration (see below) |
| • | Anterior, middle, and posterior cranial fossae |
| • | No enlargement of sella |
| Facial | • | Frontal sinuses (anatomy, pneumatization) |
| skeleton | • | Nasal cavity (width, aeration, septum on the midline) |
| • | Orbital roof and sidewalls intact |
| spine | • | Tip of dens (see below) |
| Soft tissues | • | Intact soft-tissue coverage |
| • | No swelling or foreign bodies |
Occipital View
The imaged portions of the calvaria are normal in shape, thickness, and symmetry. The lambdoid suture and other imaged cranial sutures are normal for age and display a normal course. They show proper bone structure and mineralization. The calvaria presents smooth, sharp outlines with no abnormal contour defects or fracture lines. The foramen magnum is normal in its shape, width, and margins. The cranial cavity is unremarkable. The soft tissues show no abnormalities.
Interpretation
The occiput and foramen magnum appear normal.
Checklist
| Sutures | • | Lambdoid suture and parts of the sagittal suture: open or closed (by age 18 years) |
| • | Wormian bones? (e.g., interparietal bone) |
| Structure | • | Mineralization |
| • | Sharp delineation of bony structures |
| • | No circumscribed lucencies or densities (with or without sclerosis) |
| • | Vascular channels: arteries, diploic and emissary veins (course variable, not always symmetrical, same approximate size) |
| Contours | • | Outer and inner tables smooth and sharp |
| • | No contour defects or discontinuities |
| • | No exostoses or bony excrescences |
| • | No periosteal elevation |
| Foramen | • | Shape (oval, symmetrical) |
| magnum | • | Width (see below) |
| • | Smooth, sharp inner contours |
| Cranial cavity | • | Calcifications? (If so: location) |
| • | Calcifications? (Location) |
Important Data
| 1. | Thickness of inner table: ca. 0.5 cm |
| 2. | Thickness of outer table: ca. 1.5 mm |
| 3. | Diameter of foramen magnum: ca. 3.5 mm |
(Caution: projection errors!)
Paranasal Sinuses
The paranasal sinuses and nasal cavity are normally shaped and symmetrically disposed. The nasal septum is centered on the midline. The sinuses show normal pneumatization and lucency, and their contours are smooth and sharply defined.
Imaged portions of the facial skeleton are unremarkable. There are no radiopaque foreign bodies.
Interpretation
The nasal cavities and paranasal sinuses appear normal.
Checklist
| Shape, size | • | Frontal sinus (see below) |
| • | Maxillary sinuses (see below) |
| • | Nasal cavity: symmetry, nasal septum centered |
| Pneumatization | • | Radiolucency (symmetrical except for frontal sinuses) |
| Contours | • | Smooth and sharp |
| • | No circumscribed cortical thinning or thickening |
| Other bony | • | Facial skeleton, orbits, petrous ridges: |
| structures | | — Shape (symmetry) |
| | — Contours (radiolucent lines) |
| Soft tissues | • | No foreign bodies or calcifications |
Important Data
| 1. | Frontal sinus: height = ca. 1.5–2 cm |
| 2. | Sphenoid sinus: width = 0.9–1.4 cm |
| 3. | Maxillary sinuses: width (W) and height (H) = ca. 2 cm |
Orbits, Posteroanterior View
The imaged portions of the facial skeleton are reasonably symmetrical. They show normal anatomical development with proper bone structure and mineralization. The bony orbital margins have smooth, sharp contours. The superior orbital fissure shows a...
