Rheumatoid arthritis leads to characteristic findings at the synovial joints, the intervertebral discs and the processes of the cervical spine. Isolated findings are not specific for rheumatoid arthritis. In fact, due to common underlying pathophysiologic changes they also develop in other inflammatory diseases affecting the cervical spine. Therefore, each radiological examination is to be understood and used as a piece in the diagnostic puzzle. Only in conjunction with clinical information does it add to a conclusive diagnosis. Nevertheless certain patterns of findings help in narrowing the list of differential diagnosis. Besides their role in initial diagnosis, radiological examinations are crucial tools in the peri- and post-operative work-up and in the detection of typical complications of rheumatoid arthritis with cervical manifestations, i. e. various instabilities and their consequences, as those have an impact on the therapeutic approach and prognosis.
