Not-so-normal variants.

In contrast with the widely held view that radiologic normal variants are of no clinical significance, many of the anatomic variations of the skeletal system, may, in fact, be responsible for symptoms. Three groups of apparently normal variants are presented: Group 1 consist of ossicle that, from the very onset, may represent the sequelae of repetitious trauma; Group 2 is composed of normal variants in which the presence of congenital synchondrosis may predispose to injury from chronic repetitious trauma; Group 3 consists of ossicles that predispose to local and premature degenerative changes. Radionuclide bone scanning is crucial in evaluating the significance of the ossicles in the symptomatic patient.