title: Radiological cervical spine involvement in young adults with polyarticular juvenile idiopathic arthritis.
abstract: OBJECTIVE
  Radiological cervical spine involvement in JIA has already been assessed with a large range of prevalence (5-80%), but most studies were performed a long time ago, in symptomatic JIA and without differentiating subsets of JIA. We set out to describe structural cervical spine involvement in young adults with polyarticular JIA (pJIA) regardless of the cervical symptoms and to compare lesions with those observed in adult RA.
  
  
  METHODS
  All consecutive pJIAs followed in a transition programme were included. Standard radiographs of the cervical spine, hands, feet and hip were analysed by two independent radiologists blinded to the diagnosis. An RA control group (<55 years), matched for sex and disease duration, was recruited.
  
  
  RESULTS
  Fifty-seven pJIA and 58 RA patients were included. Radiographs showed cervical lesions in 65% of pJIA and 67% of RA patients. In total, 51% of pJIA with radiographic abnormalities had no clinical symptoms. In pJIA, the most frequent structural lesions were anterior atlantoaxial subluxation (33%), erosion of the odontoid process (19%), C1-C2 arthritis (17%) and apophyseal joint arthritis (16%). Cervical lesions in pJIA were similar to those in RA except for ankylosis and hypotrophia (P < 0.05). The presence of cervical lesions correlated with a more severe disease.
  
  
  CONCLUSIONS
  Structural cervical spine involvement is common in pJIA persisting into adulthood, frequently asymptomatic and associated with a more severe disease. We suggest that radiographic assessment of the cervical spine should be done systematically at onset of the disease and regularly during its course regardless of clinical symptoms.
authors.affiliation: Department of Rheumatology A, Paris Descartes University, Sorbonne Paris cite, Cochin Hospital, Paris, France.
authors.forename: Muriel
authors.initials: M
authors.lastname: Elhai
authors.forename: Julien
authors.initials: J
authors.lastname: Wipff
authors.forename: Ramin
authors.initials: R
authors.lastname: Bazeli
authors.forename: Véronique
authors.initials: V
authors.lastname: Freire
authors.forename: Antoine
authors.initials: A
authors.lastname: Feydy
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Drapé
authors.forename: Pierre
authors.initials: P
authors.lastname: Quartier
authors.forename: André
authors.initials: A
authors.lastname: Kahan
authors.forename: Chantal
authors.initials: C
authors.lastname: Job-Deslandre
mesh_terms: D000293:Adolescent; D000328:Adult; D001171:Arthritis, Juvenile / Q000097:blood / Q000000981:diagnostic imaging*; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000000981:diagnostic imaging; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging*; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011859:Radiography; D012720:Severity of Illness Index; D013122:Spinal Diseases / Q000097:blood / Q000000981:diagnostic imaging*; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein