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_Case presentation Case1 A middle-aged male patient was presented with symptoms of radiating pain in the left cervical re- gion radiating towards left upper limb. In addition, he had movement restrictions of the neck on the left side. He had also noticed a bony lump in the left upper neck area. He consulted his neurosurgeon whoreferredthepatientdirectlytoCBCTofthecer- vical spine. On CBCT at level C3-C4 spondylotic hypertrophyoftheleftfacetjointwasfound,which led to lateral stenosis of the intervertebral foramen in addition to a bony prominence on the left side (Fig. 1). Axial, coronal and sagittal slices in addition to surface reconstructions show the changes in details. The patient is now awaiting his surgery, i.e. facetectomy at level C3-C4 after an ENMG examination to rule out nerve degeneration. Case2 A middle-aged female patient was referred to CBCT of the cervical spine for restricted neck move- ments and mild radiating pain to both upper limbs. Also a history of giddiness was elucidated. Cervical spondylosis was suspected. On CBCT images, axial, coronal and sagittal slices in addition to surface reconstructions show mild arthrosis of the bilateral facet joints at upper cervical spine and postero- lateral spondylosis at level C3-C6 (Fig.2). Minimal narrowing of the bilateral intervertebral foramina may be noticed. The patient is currently undergoing medical treatment for spondylosis. Case3 A middle-aged female patient was referred to CBCT of the cervical spine for severe radiating pain ofbothupperlimbs.Adiagnosisofcervicalspondy- losis with inter-vertebral foraminal narrowing was suspected. On CBCT axial, coronal and sagittal im- agesshowedseverebilateralintervertebralstenosis at level C4-C5 (Fig. 3). The patient is awaiting an ENMG examination after which she will undergo a surgery. _Conclusion At our clinic we have found the oblique views of plain radiographs not to be optimal enough to demonstratetheconditionofintervertebralforamina. These radiographs are neither selective nor sensi- tive. In all cases of radicular pain of the upper limbs we recommend the simultaneous use of CBCT and MRI for pre-surgical evaluation. CBCT with its low ra- diation dose is suitable for demonstration of cervical spondylosis and associatedcomplications. Ventrolateral and pos- terolateral spondylosis leading to spinal and lateral stenosis may be welldemonstratedduring presurgical evaluation. Alsorheumaticconditions of the upper cervical spine including atlanto- axial dislocation are well indicated by CBCT. More- over, hair line fractures of the cervical spine and bony lytic tumors are well demonstratedbyusingCBCT.Asaconclusion,wesug- gestthatCBCTofthecervicalspineshouldberoutinely indicatedforpatientsreferredtosurgicalintervention._ _ References 1. Paik NC. Bilateral cervical spondylolysis of C7. The Spine Journal 2010 Nov;10(11):e10–3. 2. Griffith B, Vallee P, Krupp S, et al. Screening Cervical Spine CT in the Emergency Department, Phase 3: Increasing Effective- ness of Imaging. Journal of the American College of Radiology 2013 Sep 10. pii: S1546-1440(13)00311–6. 3. JärnstedtJ,DastidarP,LinnosaariM.ENTdiagnosticimagingusing cone beam CT. Medical Imaging 2012 March/April, pp. 24–25. SCANORA 3D is a registered trademark of SOREDEX. I 43 user report _ CBCT in cervical spondylosis diagnosis I cone beam1_2014 Dr Jorma Järnstedt,DDS,specialist in dento- maxillofacial radiology atTampere University Hospital and Röntgentutka Corporation,Tampere,Finland. Dr Prasun Dastidar,MD,PhD,Neuroradiologist atTampere University Hospital and Röntgentutka Corporation,Tampere,Finland. Röntgentutka Corporation is a renowned private imaging center located inTampere,Finland. The clinic provides e.g.MRI,X-ray,ultrasound,CBCT, dentalandmammographyexaminationsperformedby modernequipmentwithlatesttechnologicalinnovations and by experienced medical professionals. SOREDEX focuses on developing innovative imaging solutions that enhance diagnostic performance for healthcare professionals.SOREDEX medical imaging systems are developed in close co-operation with leading ENT and dento-maxillofacial specialists at universities and hospitals around the world. www.soredex.com cone beam_about the authors Fig. 3 CBE0114_42-43_Soredex 31.01.14 15:54 Seite 2