To the Editor: Vertebral squaring, or straightening of the anterior border of the vertebral body, is a well recognized radiographic feature of spondyloarthritis (SpA). Squaring can be designated as a pathological change when it occurs in vertebrae in which the normal contour of the anterior border is concave. If the normal contour is not concave, it would not be possible to designate squaring as a pathological change. Although lumbar vertebrae typically have a concave anterior border, the radiographic appearance of cervical vertebrae is more heterogeneous. For example, the sagittal projections of C2 and C3 are normally square or trapezoidal. To be able to ascribe squaring as a pathological change in patients with SpA, it is necessary to know what proportion of cervical vertebrae naturally has the prerequisite concave anterior border and what proportion is naturally square on radiographs.
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