Radiological evaluation of the craniocervical junction in bone dysplasias and other related syndromes

The craniocervical junction, a vital but anatomically complex region, presents additional interpretative challenges in patients with skeletal dysplasias and other syndromes involving the musculoskeletal apparatus. Our objective was to review the radiological evaluation used in such conditions; to do so, we identified retrospectively all of the occipitocervical studies done during the last 3 years at our institution on patients with skeletal dysplasias and related syndromes. The 28 cases thus found were reviewed and the different diagnostic modalities identified; the diagnostic findings were summarized and classified into osseous and soft tissue abnormalities. The standard criteria for cervical instability and cord compression were compared with measurements reported in our selected cases. The lateral radiograph of the cervical spine was the first diagnostic test, followed by additional flexion-extension views and sagittal spin-echo magnetic resonance imaging; no conclusive diagnostic criteria for occipitoatlantal instability in children with bone dysplasias were identified.