title: Magnetic resonance imaging of the craniovertebral junction in rheumatoid arthritis.
abstract: Conventional radiography and magnetic resonance imaging (MRI) of the craniovertebral junction were evaluated in 12 patients with longstanding rheumatoid arthritis (RA) and neck pain with or without other neurologic signs or symptoms of cervical myelopathy. MRI demonstrated abnormal soft tissue masses thought to represent pannus in 9 patients. Three patients showed cord or brainstem compression due to pannus or atlantoaxial subluxation. The 3 patients with MRI evidence of cord or brainstem compression had neurologic signs or symptoms of cervical myelopathy, and appropriate therapy was instituted based on these findings. This study indicates that MRI is able to detect abnormal soft tissue masses which probably represent pannus and their relationship to the spinal cord or brainstem, and confirms the utility of the procedure in the management of craniovertebral involvement in RA.
authors.affiliation: Department of Medicine, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27103.
authors.forename: E L
authors.initials: EL
authors.lastname: Semble
authors.forename: A D
authors.initials: AD
authors.lastname: Elster
authors.forename: R F
authors.initials: RF
authors.lastname: Loeser
authors.forename: D W
authors.initials: DW
authors.lastname: Laster
authors.forename: V R
authors.initials: VR
authors.lastname: Challa
authors.forename: E J
authors.initials: EJ
authors.lastname: Pisko
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology*; D003240:Connective Tissue Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging; D005122:Exudates and Transudates; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009192:Myelography; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000000981:diagnostic imaging; D013585:Synovitis / Q000175:diagnosis / Q000000981:diagnostic imaging