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Degenerative Arthritis of Craniovertebral Junction
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Abbreviations

            • Degenerative joint disease (DJD)
          • Synonyms

            • Osteoarthrosis (OA), lateral atlantoaxial osteoarthritis, C1-C2 lateral mass arthritis
            • Osteoarthritis (out of favor although widely used; OA is not inflammatory process)
          • Definitions

            • Joint-based abnormality secondary to cartilage damage 

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Nuclear Medicine Findings

                    • C1-C2 Joint Injection

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      Selected References

                                      1. Adogwa O et al: Improvements in neck pain and disability following C1-C2 posterior cervical instrumentation and fusion for atlanto-axial osteoarthritis. World Neurosurg. 139:e496-500, 2020
                                      2. Fung M et al: Clinical and radiological outcomes of image guided posterior C1-C2 fixation for atlantoaxial osteoarthritis (AAOA). J Spine Surg. 4(4):725-35, 2018
                                      3. Buraimoh MA et al: Lateral atlantoaxial osteoarthritis: a narrative literature review. Clin Spine Surg. 30(10):433-8, 2017
                                      4. Shinseki MS et al: Association between advanced degenerative changes of the atlanto-dens joint and presence of dens fracture. J Bone Joint Surg Am. 96(9):712-7, 2014
                                      5. Elliott RE et al: Outcomes of fusion for lateral atlantoaxial osteoarthritis: meta-analysis and review of literature. World Neurosurg. 80(6):e337-46, 2013
                                      6. Yoshihara H et al: Surgical treatment for atlantooccipital osteoarthritis: a case report of two patients. Eur Spine J. 20 Suppl 2:S243-7, 2011
                                      7. Julien TP et al: Subchondral cysts of the atlantoaxial joint: a risk factor for odontoid fractures in the elderly. Spine J. 9(10):e1-4, 2009
                                      8. Finn M et al: Surgical treatment of nonrheumatoid atlantoaxial degenerative arthritis producing pain and myelopathy. Spine (Phila Pa 1976). 32(26):3067-73, 2007
                                      9. Schaeren S et al: Atlantoaxial osteoarthritis: case series and review of the literature. Eur Spine J. 14(5):501-6, 2005
                                      10. Aprill C et al: Occipital headaches stemming from the lateral atlanto-axial (C1-2) joint. Cephalalgia. 22(1):15-22, 2002
                                      11. Zapletal J et al: Radiologic prevalence of advanced lateral C1-C2 osteoarthritis. Spine (Phila Pa 1976). 22(21):2511-3, 1997
                                      12. Ghanayem AJ et al: Osteoarthrosis of the atlanto-axial joints. Long-term follow-up after treatment with arthrodesis. J Bone Joint Surg Am. 78(9):1300-7, 1996
                                      13. Chevrot A et al: C1-2 arthrography. Skeletal Radiol. 24(6):425-9, 1995
                                      14. Dreyfuss P et al: Atlanto-occipital and lateral atlanto-axial joint pain patterns. Spine (Phila Pa 1976). 19(10):1125-31, 1994
                                      15. Star MJ et al: Atlantoaxial lateral mass osteoarthritis. A frequently overlooked cause of severe occipitocervical pain. Spine (Phila Pa 1976). 17(6 Suppl):S71-6, 1992
                                      16. Genez BM et al: CT findings of degenerative arthritis of the atlantoodontoid joint. AJR Am J Roentgenol. 154(2):315-8, 1990
                                      17. Halla JT et al: Atlantoaxial (C1-C2) facet joint osteoarthritis: a distinctive clinical syndrome. Arthritis Rheum. 30(5):577-82, 1987
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Clinical Issues

                                              TERMINOLOGY

                                              • Abbreviations

                                                • Degenerative joint disease (DJD)
                                              • Synonyms

                                                • Osteoarthrosis (OA), lateral atlantoaxial osteoarthritis, C1-C2 lateral mass arthritis
                                                • Osteoarthritis (out of favor although widely used; OA is not inflammatory process)
                                              • Definitions

                                                • Joint-based abnormality secondary to cartilage damage 

                                              IMAGING

                                              • General Features

                                                • Radiographic Findings

                                                  • CT Findings

                                                    • MR Findings

                                                      • Nuclear Medicine Findings

                                                        • C1-C2 Joint Injection

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Demographics

                                                                    • Natural History & Prognosis

                                                                      • Treatment

                                                                        DIAGNOSTIC CHECKLIST

                                                                        • Consider

                                                                          Selected References

                                                                          1. Adogwa O et al: Improvements in neck pain and disability following C1-C2 posterior cervical instrumentation and fusion for atlanto-axial osteoarthritis. World Neurosurg. 139:e496-500, 2020
                                                                          2. Fung M et al: Clinical and radiological outcomes of image guided posterior C1-C2 fixation for atlantoaxial osteoarthritis (AAOA). J Spine Surg. 4(4):725-35, 2018
                                                                          3. Buraimoh MA et al: Lateral atlantoaxial osteoarthritis: a narrative literature review. Clin Spine Surg. 30(10):433-8, 2017
                                                                          4. Shinseki MS et al: Association between advanced degenerative changes of the atlanto-dens joint and presence of dens fracture. J Bone Joint Surg Am. 96(9):712-7, 2014
                                                                          5. Elliott RE et al: Outcomes of fusion for lateral atlantoaxial osteoarthritis: meta-analysis and review of literature. World Neurosurg. 80(6):e337-46, 2013
                                                                          6. Yoshihara H et al: Surgical treatment for atlantooccipital osteoarthritis: a case report of two patients. Eur Spine J. 20 Suppl 2:S243-7, 2011
                                                                          7. Julien TP et al: Subchondral cysts of the atlantoaxial joint: a risk factor for odontoid fractures in the elderly. Spine J. 9(10):e1-4, 2009
                                                                          8. Finn M et al: Surgical treatment of nonrheumatoid atlantoaxial degenerative arthritis producing pain and myelopathy. Spine (Phila Pa 1976). 32(26):3067-73, 2007
                                                                          9. Schaeren S et al: Atlantoaxial osteoarthritis: case series and review of the literature. Eur Spine J. 14(5):501-6, 2005
                                                                          10. Aprill C et al: Occipital headaches stemming from the lateral atlanto-axial (C1-2) joint. Cephalalgia. 22(1):15-22, 2002
                                                                          11. Zapletal J et al: Radiologic prevalence of advanced lateral C1-C2 osteoarthritis. Spine (Phila Pa 1976). 22(21):2511-3, 1997
                                                                          12. Ghanayem AJ et al: Osteoarthrosis of the atlanto-axial joints. Long-term follow-up after treatment with arthrodesis. J Bone Joint Surg Am. 78(9):1300-7, 1996
                                                                          13. Chevrot A et al: C1-2 arthrography. Skeletal Radiol. 24(6):425-9, 1995
                                                                          14. Dreyfuss P et al: Atlanto-occipital and lateral atlanto-axial joint pain patterns. Spine (Phila Pa 1976). 19(10):1125-31, 1994
                                                                          15. Star MJ et al: Atlantoaxial lateral mass osteoarthritis. A frequently overlooked cause of severe occipitocervical pain. Spine (Phila Pa 1976). 17(6 Suppl):S71-6, 1992
                                                                          16. Genez BM et al: CT findings of degenerative arthritis of the atlantoodontoid joint. AJR Am J Roentgenol. 154(2):315-8, 1990
                                                                          17. Halla JT et al: Atlantoaxial (C1-C2) facet joint osteoarthritis: a distinctive clinical syndrome. Arthritis Rheum. 30(5):577-82, 1987