European Journal of Cardiovascular Medicine

The cranio-vertebral junction (CVJ) is a complex transition region between base of skull and upper cervical spine. This study aimed to evaluate clinical features, radiological findings and various causes of CVJ disorders. It was a hospital-based prospective observational study from November 2021 to November 2022 in the Department of Radiology, RIMS, Ranchi, a tertiary care hospital of Jharkhand, India. A total of 62 cases were studied. Cranio-vertebral junction anomalies are more common in males than females with a ratio of approximately 1.7:1. Second and third decades are most common ages of presentation making up 19 cases in our study. 16 patients were above the age of 60 years. Most common presenting symptom was neck pain which 26 patients were having as their predominant complaint followed by limb weakness. Developmental anomalies were most common accounting for 51% followed by traumatic (15%) and then degenerative (13.33%). History of trauma was present in 15 patients of which 6 had developmental anomalies which were precipitated by trauma and 9 had history of pure trauma without any underlying developmental anomaly. Atlato-axial dislocation (AAD) was the most common CVJ anomaly seen in almost 60% of patients followed by basilar invagination seen in 36.66%. Os odontoideum is more common in males than females. In all 4 patients of CVJ tuberculosis, one had history of active pulmonary tuberculosis while in rest three there  was past history of pulmonary tuberculosis. Rheumatoid arthritis was present in all patients for a duration of more than 5 yrs. AAD was found in all whereas basilar invagination was seen in 2 patients. Radiographs of the cervical spine should be performed 2 years after diagnosis of  Rhematoid arthritis(RA) and periodically thereafter. Degenerative changes affecting the cervical spine may mimic CVJ anomalies