Radiologic Prevalence of Advanced Lateral C1-C2 Osteoarthritis

Study Design: The lateral C1-C2 (atlantoaxial) joints were evaluated retrospectively in 355 patients referred for radiographs of the paranasal sinuses.

Objectives: To determine the radiologic prevalence of advanced lateral atlantoaxial osteoarthritis.

Summary Of Background Data: Previous studies have shown a relation between atlantoaxial osteoarthritis and referred pain in the suboccipital region. However, the radiologic prevalence of this degenerative disorder is unknown.

Methods: Five hundred radiographs of the paranasal sinuses were evaluated retrospectively. Both lateral atlantoaxial joints were clearly visible on occipitofrontal projections in 355 examinations. Each lateral atlantoaxial joint was considered severely degenerated when advanced narrowing or obliteration of the joint space, subchondral sclerosis, and/or osteophytosis were present.

Results: Atlantoaxial osteoarthritis was found in 4.8% of the patients. The radiologic prevalence of advanced degenerative changes at the lateral atlantoaxial joint(s) was found to increase with age, ranging from 5.4% in the sixth decade to 18.2% in the ninth decade of life.

Conclusion: Because advanced degenerative changes at the lateral atlantoaxial joints can cause suboccipital neck pain, these findings should be included in the differential diagnosis in older patients with this symptom.