Imaging Evaluation of the Pediatric Craniovertebral Junction

The craniovertebral junction is imaged in both head and cervical spine imaging. An understanding of the normal morphometric appearance and common anatomic variants of this region is important for making correct diagnoses and avoiding misinterpretation, e.g., differentiating trauma from congenital variants. We describe a practical approach to evaluating the pediatric craniovertebral junction and recognizing common variants using annotated images. Pathology of the craniovertebral junction, including platybasia, basilar invagination, and traumatic injury, is illustrated, and syndromic associations of these findings are reviewed.Learning Objective: Review normal and variant anatomy of the pediatric craniovertebral junction and describe useful measurements for evaluating for traumatic and nontraumatic conditions in children.