There are levels of restricted motion (hyposegmentation anomalies, operative fusions or acquired autofusions)

There are abnormal developmental anomalies affecting the C1 ring, C2 pars, and the dens

There is evidence of chronic arthropathy disorders affecting the spinal canal width (PLL traction spurs, OPLL, DISH, CPPD)

There is evidence of underlying inflammatory arthropathy possibly increasing or decreasing spine mobility (JRA, RA, psoriatic arthritis, etc.)

There is underlying bone pathology not related to trauma, but which could have a pathologic fracture

There is abnormal widening of dens tip to basion distance (or avulsion fracture of the clival tip) indicating apical ligament disruption

There is abnormal malalignment of the cervical canal with the foramen magnum

There is an abnormal X-lines indicating the dens is abnormally displaced

The occipital condylar-C1 lateral mass bone margins are not apposed correctly, and there is increased joint fluid indicating capsular injury

The lateral mass of C1 and the shoulders of C2 facet margins are not apposed correctly, and there is increased joint fluid indicating capsular injury

Dens position and the width of the atlanto-axial joint space are abnormal and there is increased joint effusion

There is discernible discontinuity of the high cervical ALL, PLL, spinolaminar, or tectal membrane including its' attachment on the clivus, or of the cruciform ligament (including transverse and apical components)

There is fracture of either occipital condyles; include assessment of an occipital bone fracture extending into the condyle

There is a fracture of the C1 ring, or there is bilateral translational offset of the lateral masses of C1 relative to C2 (in AP plane) also consistent with a C1 ring fracture (or Jefferson's Fx) even if the fracture line is not discernible

There is fracture of the dens (3 types)

There is abnormal cortical rim fracture or medullary buckle or compression in the C2 body indicating fracture, especially at subdental synchondrosis

There is abnormal appearance of any bone component indicating underlying hypodense nontraumatic pathology.

There is evidence spinal cord or upper cervical nerve root injury

There is evidence of spinal canal for foramen magnum stenosis, either related to acute post traumatic injury (fractures or hematomas) or prior underlying conditions.

There is evidence of post traumatic soft tissue paravertebral (prevertebral, or posterior cervical, or atlanto-occipital space) edema

There is evidence of a cervical bone fracture (either linear, spiral, or trabecular in the cervical region below C2), possibly not evident on CT, which is evident on MR as cortical discontinuity or hyperintensity either within the fracture line or within the medullary portion or a vertebral body

There is discernible discontinuity of the major ligaments (i.e. transverse, alar, apical, ALL, PLL interspinous), the tectorial membrane nor its attachment on the clivus

There is disc edema (annular margin of disc itself) and widening of one or more disc spaces inidcating injury to the disc and likely the adjacent major ligaments

There is ligamentous edema and focal widening within any intra-laminar or intraspinous spaces

There is focal edema or adjacent hematoma in major ligamentous avulsion sites (anterior or posterior corner fractures)

There is focal facet misalignment with capsular joint space effusion consistent with articular capsular injury

There is significant prevertebral or other soft tissue edema or hemorrhage

There is extraaxial hematoma along the clivus or anywhere within the spinal canal

There is intraspinal, retropulsed bone fragment or acute HNP

There is spinal cord injury (compressive deformity, cord edema or cord hermorrhage

There is foraminal edema, hematoma, extravasation of CSF, or deformity of the root sleeve to suggest root or root sleeve injury

There is evidence of either carotid or vertebral artery injury or occlusion

There is evidence of prevertebral, paravertebral, or visceral soft tissue edema or other injury, which confirms traumatic injury or might explain neck pain in the absence of overt vertebral injury.

No other significant imaging findings are present.