title: Radiographic changes of cervical spine in rheumatoid arthritis.
abstract: BACKGROUND
  The involvement of the cervical spine is a common feature of rheumatoid arthritis (RA).
  
  
  OBJECTIVE
  To study the prevalence of radiographic changes of the cervical spine in patients with RA and their association with clinical and serological profiles of the disease.
  
  
  METHODS
  We analysed lateral (neutral position, hyperextension, hyperflexion) and transoral views of cervical spine radiographs from 80 individuals with RA to investigate the presence of atlanto-axial subluxation (AAS), basilar invagination (BI), and subaxial instability (SAI). Demographic, clinical (nodules, interstitial pneumonitis, secondary Sjögren's syndrome, medications etc.), and serologic (rheumatoid factor--RF, cyclic citrullinated peptide antibody--anti-CCP, and antinuclear factor--ANF) data were obtained from the clinical records.
  
  
  RESULTS
  Cervical spine misalignments were identified in 26/80 (32.5%) participants; AAS occurred in 12/80 (15%) participants, BI in 6/80 (7.5%), and SAI in 13/80 (32.5%). Odontoid erosions were identified in 16/80 (20.0%) participants. Cervical spine misalignment exhibited associations with age at onset and disease duration (P = 0.03 and 0.02, respectively). No associations were identified between the cervical spine changes and the participants' ethnicity or gender, presence of nodules, interstitial pneumonitis, secondary Sjögren's syndrome, RF, ANF, or anti-CCP. The participants with cervical spine misalignment exhibited higher frequencies of odontoid erosion (P = 0.03).
  
  
  CONCLUSIONS
  Cervical spine misalignment was a common radiographic finding and occurred more frequently in participants with earlier onset and longer length of RA.
authors: Juan Marcelo Fernandez
authors: JM
authors: Alcala
authors: Diogo
authors: D
authors: Douat
authors: Diogo Lago
authors: DL
authors: Pinheiro
authors: Douglas Jun
authors: DJ
authors: Kamei
authors: Fábio Raimundo M
authors: FR
authors: dos Santos
authors: Marilia B
authors: MB
authors: Silva
authors: Thelma L
authors: TL
authors: Skare
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000000981:diagnostic imaging*; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography