Female, 40 years old, with rheumatoid arthritis and severe pain with downward head and sideways head movement. Spinal alignment is anatomic. In particular, the craniocervical junction is normal. No evidence is seen to suggest C1-C2 instability on this non-dynamic examination.Vertebral body height and morphology are unremarkable. No concerning marrow replacement or marrow edema is seen.The visualized spinal cord is normal in signal intensity and morphology.C2-3: Left facet hypertrophy. Mild left foraminal narrowing. Mild interval progression.C3-4: Left facet hypertrophy. No significant spinal canal or neuroforaminal stenosis. C4-5: Mild facet hypertrophy. Minimal right foraminal narrowing. No significant interval changes.C5-6: Mild facet hypertrophy. Suspected small annular fissure seen on the prior examination is no longer visualized. No significant spinal canal or foraminal stenosis. C6-7: Mild facet hypertrophy. No significant spinal canal or neuroforaminal stenosis. C7-T1: Mild facet hypertrophy. No significant spinal canal or neuroforaminal stenosis.
1.No evidence of C1-2 instability on this non-dynamic examination.2.No other significant finding which would account for the patient's symptoms.