Rheumatoid arthritis and neck pain. There is 6 mm anterior subluxation of the left C1 inferior facet relative to the C2 superior facet, which is unchanged compared to prior MRI. Alignment of the rest of the cervical spine is within normal limits. Again noted is mild superior subluxation of the tip of the dens superiorly. There is no evidence of significant change when compared to prior MRI study. The tip of the odontoid is above the Wackenheim line, which is abnormal. However, the odontoid tip is inferior to the McRae foramen magnum line, and intersect with the Chamberlain line, which is still within normal limits. There is impression of the dens on the ventral aspect of the cervicomedullary junction, which was best seen on the prior MRI study. Accounting for technical differences, there is no evidence of interval change. The atlantodental distance is slightly increased, measuring 5.5 mm. The spinal canal at the C1 level is slightly narrowed to 9 mm. The rest of the cervical spine demonstrates mild arthritic changes of the facet joints seen at multiple levels, but there is no spinal canal or neuro-foraminal compromise.This a hypodense nodule in the right thyroid gland, measuring 1.2 x 1.7 ccm approximately. There is no associated calcification.
1. Arthritic changes at C1-C2 level, with mild superior subluxation of the dens and narrowing of the spinal canal, resulting in impression on the cervicomedullary junction. No significant interval change compared to the prior MRI study. 2. Right thyroid nodule. Please correlate with other clinical parameters. 