This paper discusses occipitalization of the atlas and its relationship to the chiropractic practitioner. Patients commonly consult a chiropractor with complaint of headache, suboccipital stiffness, restricted motion, dizziness and other symptoms related to the upper cervical region. Differential diagnosis of the exact etiological factor of these symptoms must be made via a thorough history, physical examination, and roentgenological examination. If occipitalization of the atlas is detected on the initial roentgenological examination, then follow-up magnetic resonance imaging, computerized tomography or linear tomographic studies may be warranted to rule out concomitant diverse osseous and/or neural anomalous conditions of the cervical spine which may easily mimic symptoms of disorders commonly treated by the chiropractic practitioner. The chiropractic practitioner must obtain appropriate roentgenological and other diagnostic imaging studies to ensure proper evaluation of the structural integrity of the cervical spine before appropriate treatment can be rendered.
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