The craniocervical junction and/or C7-T1 are not entirely included on the exam.

The exam is over or under penetrated.

The exam is limited by overlying structures, bones or soft tissues, body habitus, patient positioning, support devices, or motion.

The soft tissues anterior to C1-C7 are widened or the prevertebral fat stripe is not seen.

The paravertebral soft tissues are abnormally widened.

There is calcification, foreign body, abnormal air, or other abnormal density in the prevertebral or paravertebral soft tissues.

The distance between the basion and the posterior axial line is > 12 mm.

The distance between the basion and the tip of the dens is > 12 mm.

The atlanto-axial joint distance is > 2 mm on the lateral view.

The distance between the dens and the lateral masses of C1 is abnormally asymmetrically widened on an odontoid or AP view.

The lateral mass(es) of C1 abnormally override(s) the articular pillar(s) of C2 on an odontoid or AP view.

The anterior vertebral body line, posterior vertebral body line, articular pillar line, and/or spinolaminar line is/are abnormal.

The articular pillars or lateral masses, lamina, or other posterior elements are rotated or displaced into the spinal canal or the interlaminar clear zone of the spinal canal.

The visualized spinous processes are malaligned on the AP view or distracted on the lateral view.

There is reversal or straightening of the normal lordosis or abnormal angulation/curvature or motion of the cervical spine on frontal, lateral, flexion and/or extension views.

There is a fracture or deformity of the base of the skull or occipital condyles.

There is a fracture or deformity of the anterior or posterior arch of C1.

There is a fracture or deformity of the lateral mass(es) of C1.

There is a fracture or deformity of the dens or C2 vertebral body.

There is a fracture or deformity of the pars interarticularis/articular pillars or other posterior elements of C2.

There is a fracture or distraction of a C3-T1 vertebral body, transverse or spinous process, or other posterior element.

There is evidence of an end plate avulsion or other fracture.

There is displacement of a fracture fragment into the soft tissues, spinal canal, or interlaminar clear zone of the spinal canal.

There is anterior wedging or compression of a vertebral body or end plate.

There is evidence of an aggressive disease process manifest as a lytic, sclerotic, or destructive abnormality of a vertebral body, end plate, pedicle, lamina, articular pillar, transverse or spinous process.

There is focal or diffuse abnormal mineralization.

There is distraction or focal widening of a disc space.

There is anterolisthesis, retrolisthesis, subluxation, or rotational abnormality of a disc space.

There is widening, rotational abnormality, or displacement of facets at any motion segment (e.g. locked or jumped, perched facets, or fracture dislocation).

There is disc space narrowing with or without erosive or sclerotic changes of the end plates other than from degenerative change.

There is facet joint narrowing or sclerosis other than from degenerative change.

The included maxillofacial region, thoracic spine, ribs, or other bones of the upper thorax are abnormal.

There is air or a foreign body or other abnormality in the soft tissues of the lower head, neck or upper thorax.

There is an apical mass, thickening, pleural cap or effusion, or pneumothorax.

The airway is narrowed or displaced.

There are post surgical changes of the bones or soft tissues of the lower head, neck, or upper thorax.

There is an abnormality or complication of post-surgical hardware.

There are support lines or tubes in an abnormal position.

There are degenerative changes or other existing conditions that might be contributing to symptoms which can or should be further evaluated non-emergently.