title: Atlantoaxial laxity in rheumatoid arthritis.
abstract: We found that 14 of 162 rheumatoid arthritis patients with chronic occipitocervical pain had anterior atlantoaxial instability in the absence of any corresponding radiographic changes in the joint cartilage or subchondral bone. Our findings suggest that ligamentous instability is a prerequisite for this type of change. At the time of the detection of the instability, the median duration of disease was 12 (6-28) years. Rheumatoid occipitocervical pain may be initially caused by facet-joint arthritis or inflammation in the ligaments, and at a later stage also by irritation of the C2 nerve roots.
authors.affiliation: Fourth Department of Medicine, Helsinki University Central Hospital, Finland.
authors.forename: Y T
authors.initials: YT
authors.lastname: Konttinen
authors.forename: S
authors.initials: S
authors.lastname: Santavirta
authors.forename: M
authors.initials: M
authors.lastname: Kauppi
authors.forename: H
authors.initials: H
authors.lastname: Isomäki
authors.forename: P
authors.initials: P
authors.lastname: Slätis
authors.forename: M
authors.initials: M
authors.lastname: Hämäläinen
authors.forename: M
authors.initials: M
authors.lastname: Sakaguchi
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001268:Atlanto-Axial Joint / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D008875:Middle Aged; D011859:Radiography; D012720:Severity of Illness Index; D013997:Time Factors