PMC8422533_01
Sagittal (a) and axial (b) sections of magnetic resonance images of the craniocervical junction, presenting an expansive lesion in the posterior aspect of the odontoid process, with. Low signal at both T1 (a) and T2 (b). There is no evidence of spinal cord compression.
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F1
A 72-year-old male presented with neck pain alone, no neurological deficit, and a cervical MR that showed an expansive lesion posterior to the odontoid process [Figure 1].
PMC8422533_02
Sagittal sections from preoperative magnetic resonance imaging (a-c) indicating tissue formations that suggest an expansive process at the atlantodental joint, with low signal at T1 (a), intense enhancement after contrast injection (b) and heterogeneous signal at T2 (c). In (d), it is presented an axial section of a computed tomography image of the cervical spine obtained at the immediate postoperative period of occipitocervical arthrodesis; the arrow points to the calcification halo around the axon odontoid process. In (e) and (f), it is presented the final result of the occipitocervical arthrodesis.
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F2
Here, the cervical MRI revealed an intense inflammatory reaction involving the atlantoaxial joint (i.e. hyperintense T2 signal in anomalous tissue around the axis dens, with widening of the atlantodental interval) [Figure 2].