Forty-five non-rheumatoid patients with chronic chest disease were examined radiographically for evidence of cervical subluxation. Twenty-six patients had received continuous corticosteroids for periods of between two and 20 years. The remainder (19 patients) had never been treated with steroids and acted as controls. There was no difference in atlanto-axial distance between the steroid-treated and control groups and in no patient did this measurement exceed 3 mm. However, subaxial subluxation was significantly increased in the steroid-treated group, directly related to the duration of steroid therapy (P < 0.025)