• Normal alignment and segmentation with just mild straightening of the normal cervical lordosis. There is minor upper cervical facet OA
• There is an increase in the predental space with horizontal atlanto-axial subluxation. The dens is just below mcgregors line so there is no convincing basilar invagination. The dens does however contact the cervicomedullary junction with no deformity or compression.
• There is some erosion at the base of the dens with pannus ossification around the anterior arch of C1 with at least partial fusion to the dens. No active pannus formation is seen.
• The overall imaging features would be consistent with chronic rheumatoid arthritis.