Craniocervical junction involvement in musculoskeletal diseases: an area of close collaboration between rheumatologists and radiologists

The involvement of the cervical spine in musculoskeletal diseases can be crucial in terms of prognosis and morbidity. Early diagnosis of possible involvement of the craniocervical junction is essential to avoid the onset of neurological complications with poor prognosis. Among inflammatory diseases, rheumatoid arthritis affects the cervical spine frequently (in about 25% of patients). Atlantoaxial inflammatory changes are also detectable in spondyloarthritis. The involvement of the cervical spine in diffuse idiopathic skeletal hyperostosis is recognized as the cause of various clinical manifestations that may involve the pharynx, larynx and esophagus. The cervical spine may be specifically frequently implicated in crystal-associated arthropathies. Spinal cord infections are infrequent diseases that account for 3–4% of all spine infections. This pictorial review attempts to provide insights to interpret the radiological appearances of the craniocervical junction on conventional radiography, computed tomography and magnetic resonance imaging in relation to various musculoskeletal disease processes.