Cervical spondylitis has been reported in 35-75% of patients with PsA. The clinical and radiological changes of the cervical spine were evaluated in 75 patients with PsA. Cervical spine involvement was found in 45% of those examined and 36% of patients X-rayed. The pattern of disease was ankylosing in 85% of patients, characterized by ankylosis, syndesmophytes and ligamentous ossification. Twelve per cent had radiological evidence of cervical spondylitis without clinical evidence of disease. The major predictor of cervical spine disease was the duration of psoriatic arthropathy. Cervical spondylitis was not related to disease severity, extent of skin or nail involvement and neither did it reflect any homogeneous pattern of disease.