Radiological cervical spine involvement in patients with rheumatoid arthritis: a cross sectional study.
OBJECTIVE
To investigate the frequency and the severity of radiological cervical spine involvement in patients with rheumatoid arthritis (RA).


METHODS
We investigated 165 consecutive unselected patients with RA who fulfilled the revised American College of Rheumatology criteria for RA. All patients had a complete physical and laboratory evaluation. Patients had a radiological evaluation that included hand and wrist radiographs, as well as cervical spine radiographs in anteroposterior, lateral, and lateral in full flexion views. Hand radiographs were evaluated according to the Larsen criteria, while cervical radiographs were evaluated according to Winfield classification.


RESULTS
There were 143 women and 22 men, with a mean age of 59.6 +/- 12.5 and disease duration 12.3 +/- 13.9 years. Positive rheumatoid factor was found in 63.6% of patients. One hundred forty-six patients presented radiological findings related to cervical spine involvement: atlantoaxial subluxations were found in 20.6% and erosions of the odontoid process in 2.4%; none presented vertical subluxation. Subaxial subluxations were found in 43.6%, disc space narrowing at C2-C3, C3-C4, C4-C5 levels in 66.1%, and vertebral plate sclerosis and erosions in 43.6%.


CONCLUSIONS
Cervical spine radiological involvement is a frequent finding in our patients with RA, but the severity of the disease is rather mild, possibly related to the ethnic background.
Zikou
Anastasia K
AK
Department of Radiology, Medical School, University of Ioannina, Ioannina, Greece.
Alamanos
Yannis
Y
Argyropoulou
Maria I
MI
Tsifetaki
Niki
N
Tsampoulas
Constantinos
C
Voulgari
Paraskevi V
PV
Efremidis
Stavros C
SC
Drosos
Alexandros A
AA
D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000453:epidemiology*; D001268:Atlanto-Axial Joint / Q000000981:diagnostic imaging* / Q000473:pathology; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000473:pathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011859:Radiography; D012720:Severity of Illness Index
D018501:Antirheumatic Agents