The diagnosis of crural cervical spondylosis can only be made when supported by both symptoms and imaging findings. (i) X-ray radiographs X-ray radiographs may reveal narrowing of the intervertebral space, osteophyte formation, kyphosis, subluxation, and spinal stenosis, and cervical instability is considered to be present when the position of one vertebral body relative to the neighboring vertebrae changes by more than 3.5 mm on hyperextension and hyperflexion radiographs. (ii) Cervical CT CT is useful in the evaluation of spinal stenosis, and can show bone encumbrances more clearly than radiographs. It can also show the intervertebral foramina and help to detect the ossification of the posterior longitudinal ligament. （MRI of the cervical spine is particularly important for the diagnosis of crural cervical spondylosis because it can show pathologic changes in the neural structures, and detect compression of the crural cord and damage to the crural cord itself. Inflammation, edema, ischemia, degeneration, and softening can increase the signal intensity of the cremasteric medulla on T2-weighted images, and dynamic MRI in the flexion position can reveal areas of high signal on T2-weighted images that are not detected on neutral MRI. Diffusion-weighted imaging (DWI), especially diffusion tensor imaging (DTI), can increase the sensitivity of diagnosing crural cervical spondylosis. In addition, MRI is able to be used to identify crural damage from non-cervical causes. (iv) Cristal myelography Cristal myelography can be used in patients who cannot undergo MRI, and it has similar sensitivity and specificity to MRI, and can be performed simultaneously with cerebrospinal fluid examination. However, MRI is still more advantageous because it can understand bone changes, elevated cranial pressure is not a contraindication to the examination, and patients are more comfortable during the examination. Also when there is subarachnoid obstruction, cristografia is limited. (v) Neurophysiologic Examinations Electromyography (EMG), nerve conduction velocities (NCSs), motor evoked potentials (MEPs), and somatosensory evoked potentials (SEPs) can be used to differentiate crural cervical spondylosis from peripheral neuropathies and muscular lesions. 1, EMG. Evidence of muscle denervation in crural myelopathy, radiculopathy, or other peripheral neuropathies can be found. 2, Nerve conduction velocity. Because the distal portions of peripheral nerves are normal, nerve conduction velocities are normal in crural cervical spondylosis and radiculopathy unless extensive axonal or upper motor neuron damage is present. In contrast, in peripheral neuropathy, nerve conduction velocities are slowed. In cases presenting purely with motor dysfunction, a combination of nerve conduction velocity and electromyography can help diagnose or rule out motor neuron disease. 3. Evoked potentials. Motor and somatosensory evoked potentials have been shown to have abnormal results in a range of neurologic dysfunction disorders, such as crural cervical spondylosis and neurogenic cervical spondylosis, and this can be used to evaluate the severity of the disease. Somatosensory evoked potentials have been reported to have similar sensitivity and specificity to MRI, whereas motor evoked potentials are more sensitive than somatosensory evoked potentials in the diagnosis of early crural myelopathy; however, evoked potentials are not commonly used in the diagnosis and treatment of crural cervical spondylosis, and tend to be used for intraoperative monitoring of crural cervical spondylosis. (vi) Hematologic and cerebrospinal fluid tests can be used to confirm or rule out conditions other than crepital cervical spondylosis. Hematologic markers such as vitamin B12, folic acid, human T-lymphotropic virus type 1 (HTLV-1) and human autoimmune deficiency virus (HIV) serology, and autoimmune disease serology can be useful in searching for metabolic, infectious, and inflammatory causes of crural radiculopathy. In contrast, cell counts of cerebrospinal fluid, determination of protein and glucose levels, herpes virus polymerase chain reaction testing, and cytology of malignant tumors can help to help confirm the diagnosis of multiple sclerosis, other inflammatory-demyelinating disorders, infections, or malignant tumors involving the nervous system.