title: [Contribution of dynamic radiographs in atlantoaxial subluxation in rheumatoid arthritis].
abstract: BACKGROUND
  Cervical spine (CS) involvement is common during rheumatoid arthritis (RA) and it is distinguished by its potential gravity.
  
  
  OBJECTIVE
  To determinate the occurrence of atlantoaxial subluxation (AAS) by dynamic incidences X-Ray and to assess its predictive factors.
  
  
  METHODS
  Our study included a cohort of 40 patients carrying RA, who fulfilled the American College of Rheumatology criteria, for more than 2 years. All patients had a complete physical and laboratory evaluation. Radiological evaluation included CS radiographs in anteroposterior, lateral, and lateral in full flexion and extension views.
  
  
  RESULTS
  The occurrence of CS involvement was about 47.5% by XRay dominated by AAS which found in 42,5% of the cases. Among AAS, anterior AAS was the most frequent with a prevalence of 22,5% followed by lateral AAS in 12,5% then vertical and rotatory AAS in 10% of cases each one and posterior AAS in 2,5% of the cases. Comparison between patients with and without CS involvement indicated the presence of two predictive factors: the sharp modified score and the C - reactive protein (p=0.002 and p=0.004 respectively).
  
  
  CONCLUSIONS
  Our study demonstrated that AAS is frequent in RA particularly in active forms with structural lesions. AAS can be asymptomatic, for this reason systematic diagnosis by X-Ray with dynamic views is important.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Younes
authors.forename: Haifa
authors.initials: H
authors.lastname: Hachfi
authors.forename: Safa
authors.initials: S
authors.lastname: Belghali
authors.forename: Sameh
authors.initials: S
authors.lastname: Ben Hammouda
authors.forename: Soulef
authors.initials: S
authors.lastname: Kriâa
authors.forename: Soussen
authors.initials: S
authors.lastname: Zrour
authors.forename: Ismail
authors.initials: I
authors.lastname: Bejia
authors.forename: Mongi
authors.initials: M
authors.lastname: Touzi
authors.forename: Elyes
authors.initials: E
authors.lastname: Bouajina
authors.forename: Naceur
authors.initials: N
authors.lastname: Bergaoui
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000150:complications*; D001268:Atlanto-Axial Joint / Q000000981:diagnostic imaging* / Q000293:injuries*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography