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Related Experiment Videos

[Rheumatoid arthritis at the cervical spine -- an underestimated problem].

M Schwarz-Eywill1, R Friedberg, F Stösslein

  • 1I. Medizinische Klinik, Schwerpunkt Rheumatologie/Klinische Immunologie, Klinikum Dresden-Friedrichstadt, Dresden.

Deutsche Medizinische Wochenschrift (1946)
|August 25, 2005
PubMed
Summary

Early MRI detection of cervical spine disease in rheumatoid arthritis (RA) is crucial for preventing fatal complications. Imaging, including MRI, is essential for timely surgical intervention and risk assessment in RA patients.

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Area of Science:

  • Rheumatology
  • Orthopedics
  • Radiology

Background:

  • Cervical spine involvement in rheumatoid arthritis (RA) significantly impacts prognosis and mortality.
  • Cervical myelopathy, caused by pannus or subluxation, can be life-threatening.
  • Early identification of cervical spine changes in RA is critical.

Purpose of the Study:

  • To identify MRI-detectable changes in the cervical spine of RA patients.
  • To establish a risk profile for individual RA patients with cervical spine involvement.
  • To assess the correlation between clinical findings and MRI results.

Main Methods:

  • 214 patients with active RA were included over 24 months.
  • Clinical and laboratory data were collected, along with plain cervical spine radiographs.

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  • MRI was performed on 36 patients with pathological X-ray findings.

    • Main Results:

    • MRI revealed significant cervical spine changes in all 36 patients.
    • Atlanto-axial subluxation was present in 69.5%, pannus around the dens in 19.5%, and spondylodiscitis below C2 in 19.5%.
    • Cervical myelopathy was observed in 27.8%, with 50% showing neurological deficits, leading to death in 30% and successful surgery in 20%.

    Conclusions:

    • Early detection of cervical spine involvement in RA via radiography and MRI is vital to prevent fatal outcomes.
    • This diagnostic approach helps determine optimal timing for surgical intervention.
    • Cervical spine involvement in RA remains underestimated in clinical practice.