title: The cervical spine in mutilant juvenile chronic arthritis.
abstract: OBJECTIVE
  To describe inflammatory cervical spine disorders in juvenile chronic arthritis (JCA) patients with arthritis mutilans (AM) hand deformity.
  
  
  METHODS
  The series consisted of 18 patients affected by AM hand deformity who fulfilled the European League of Associations for Rheumatology criteria for JCA. The patient records and the most recent cervical spine radiographs were evaluated for subluxations, atlantoaxial impaction (AAI) and apophyseal joint ankylosis.
  
  
  RESULTS
  Seventeen (94%) patients had subluxation, AAI or apophyseal joint ankylosis in the cervical spine. Apophyseal joint ankylosis was noted in 12 (67%) patients and AAI in 10 (56%). Anterior atlantoaxial subluxation was detected in five (28%) patients.
  
  
  CONCLUSIONS
  Almost all of the JCA patients with AM hand deformity evinced some inflammatory changes in the cervical spine. Apophyseal joint ankylosis, AAI and multiplicity of changes in cervical spine may be considered characteristic in this subset of JCA patients. Patients with JCA and AM hand deformity tend to have severe changes also in the cervical spine.
authors.affiliation: Rheumatism Foundation Hospital, Heinola, Finland. kari@laiho.as
authors.forename: K
authors.initials: K
authors.lastname: Laiho
authors.forename: M
authors.initials: M
authors.lastname: Kauppi
authors.forename: A
authors.initials: A
authors.lastname: Savolainen
authors.forename: E A
authors.initials: EA
authors.lastname: Belt
mesh_terms: D000293:Adolescent; D001171:Arthritis, Juvenile / Q000150:complications / Q000000981:diagnostic imaging*; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000473:pathology*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006227:Hand Deformities, Acquired / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011859:Radiography; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D013167:Spondylitis, Ankylosing / Q000150:complications / Q000000981:diagnostic imaging*