Atlantoaxial facet joint arthritis in the rheumatoid cervical spine. A panoramic zonography study.
Twenty-three patients with severe, longterm (22 years, range 8-36) rheumatoid arthritis were evaluated for rheumatoid changes in the atlantoaxial facet joints using a panoramic zonography program. Ten patients had vertical subluxation of the odontoid process. In 9 of 10 cases this mode of subluxation was associated with grade 3-4 arthritis in the facet joints. Our findings indicate atlantoaxial facet joint arthritis with bilateral collapse of the lateral facet joint masses as a cause of vertical subluxation. Furthermore, we suggest that panoramic zonography investigation is a valuable contribution to the pattern of radiographic examination of the atlantoaxial facet joint arthritis, especially for evaluation of its clinical counterparts: nonreducible lateral head tilt and vertical atlantoaxial subluxation.
Santavirta
S
S
Surgical Hospital, Division of Orthopedics and Traumatology, Helsinki, Finland.
Hopfner-Hallikainen
D
D
Paukku
P
P
Sandelin
J
J
Konttinen
Y T
YT
D001172:Arthritis, Rheumatoid / Q000150:complications / Q000000981:diagnostic imaging*; D001268:Atlanto-Axial Joint / Q000000981:diagnostic imaging* / Q000293:injuries; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging; D009192:Myelography; D009333:Neck; D013117:Spinal Cord Compression / Q000209:etiology / Q000601:surgery; D013122:Spinal Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D013131:Spine / Q000000981:diagnostic imaging*; D014056:Tomography, X-Ray