Cranial settling - rheumatoid arthritis

Case contributed by Henry Knipe



Patient Data

Age: 70 years
Gender: Female

No intra- or extra-axial collection or hemorrhage. No focal abnormality. Grey-white differentiation is preserved. Ventricular size, sulcal pattern and basal cisterns all appear normal.

Basilar invagination is present with narrowing of the craniocervical junction and mildly impresses on the medulla oblongata/cervical spinal cord. The dens is mildly expanded and sclerotic/irregular with well-circumscribed lobulated lucency/erosion at the posterior aspect of the base of the dens.

Case Discussion

Cranial settling is a term used to describe basilar invagination in the setting of rheumatoid arthritis, of which this patient had a history of. In this case, this was an incidental finding.

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