[Structural changes on hands as predicative factors of structural changes in the cervical spine and atlantoaxial...

Determination of changes in the cervical spine of patients with rheumatoid arthritis (RA) is important. Although they are often clinically asymptomatic, during exercise therapy complications, or even death, may occur. The aim of the study was to determine the factors which indicate changes in the cervical spine and atlantoaxial joint (AA) in patients with RA, as well as the association between those changes and changes occurring on the hands. The study included 80 patients with RA who were divided into two groups according to the duration of the disease (up to 10 years and more than 10 years). Structural changes in the hands and cervical spine were monitored by ordinary radiography. Structural changes in the cervical spine were found in both groups of patients without a statistically significant difference between them (p = 0.165). The AA joint was more often deformed in patients with a longer duration of the disease (p = 0.012). The changes on the hands were worse in patients who had the disease for longer than 10 years (p = 0.002), and they correlated with AA subluxation (p = 0.002) and luxation (p = 0.004), as well as with an erosion of the cervical s pine (p = 0.000). According to our findings, in order to recognize changes in the cervical spine, patients with RA must be regularly monitored radiographically, and monitoring should be mandatory in patients who had a longer duration of the disease as well as those with more advanced structural changes on the hands.