Abstract
BackgroundClinical evaluation in the determination of the etiology of axial spine pain is limited. ObjectiveTo determine if a set of three features of the clinical history are indicative of C1-2 joint edema on MRI. MethodsAll 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. ResultsThe 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. ConclusionA positive ASL criteria is sensitive and specific in the diagnosis of C1-2 joint edema, which may have clinical implications.
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