Atlanto-odontoid osteoarthritis in rheumatoid arthritis: dynamic CT findings.
We analyzed the CT appearances of degenerative change in the atlanto-odontoid joint (AOJ) in patients with rheumatoid arthritis (RA) and evaluated the effect of these changes on atlanto-axial joint (AAJ) rotation by dynamic CT. This revealed that 9 patients (24%) treated with methotrexate had degenerative features in the AOJ. The ratio of AAJ rotation to the total rotation of the cervical spine was significantly higher in normal subjects (54 +/- 3%) than in patients (38 +/- 12%). The degree of AAJ rotation was significantly lower in the patient group with degenerative features in the AOJ (20.9 +/- 8.4 degrees ) than in patients without degenerative features (28.5 +/- 7.4 degrees ). RA patients with a history of longstanding disease and treatment with antirheumatic drugs may develop AO OA. Although secondary OA was described as healing phenomena in the joints of RA patients, it can limit rotation in the AAJ and cause suboccipital neck pain. A regular check-up of the AAJ and AOJ by means of dynamic CT in all RA patients is proposed to avoid possible antirheumatic drug complications.
Radyoloji Anabilim Dali, Inönü Universitesi Turgut Ozal Tip Merkezi, 44069, Malatya, Turkey. ozlembaysal@hotmail.com
Ozlem
O
Baysal
Tamer
T
Baysal
Ahmet
A
Sigirci
Yuksel
Y
Ersoy
Zuhal
Z
Altay
D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D001268:Atlanto-Axial Joint / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D019547:Neck Pain / Q000209:etiology / Q000473:pathology; D010003:Osteoarthritis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D014056:Tomography, X-Ray
D018501:Antirheumatic Agents; D008727:Methotrexate