Large amount of low T1 and low T2 signal periodontoid material with widening of the median atlantoaxial joint and erosions of the dens. Marrow oedema within the dens, anterior arch of C1, the lateral masses of C1 and C2, and within the left occipital condyle. Thin circumferential fluid within the epidural from C1 to C3 (best seen on STIR images). Background multilevel cervical spine disc and facet joint degeneration including C4-7 disc ankylosis and C3-4 canal stenosis due to combination of disc-osteophyte complex and ligamentum flavum hypertrophy.