Clinical history correlates with lateral atlantoaxial (C1-2) joint edema. A pilot study

Clinical evaluation in the determination of the etiology of axial spine pain is limited.

To determine if a set of three features of the clinical history are indicative of C1-2 joint edema on MRI.

All patients from one physician's practice who had axial cervical spine pain from 2021 to 2023 were evaluated. Cases were defined as those with all 3 of the ASL criteria, defined as Age >65, Superior cervical/suboccipital pain, and exacerbation of pain primarily by Lateral cervical spine rotation. Age-matched controls had axial cervical spine pain without meeting the ASL criteria. Edema around the atlantoaxial joint and/or odontoid was evaluated by STIR MR sequences.

The ASL criteria had a sensitivity of 82 % [95 % CI: 64-100 %], specificity of 79 %, [95 % CI: 63-95 %], positive predictive value of 74 % [95 % CI: 54-94 %], and negative predictive value of 86 % [95 % CI: 72-100 %] in diagnosing C1-2 joint edema.

A positive ASL criteria is sensitive and specific in the diagnosis of C1-2 joint edema, which may have clinical implications.