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Craniocervical junction involvement in inflammatory arthritis: a single-center radiologic study
Fatma Yalçinkaya1, Şafak Parlak Sağol2, Aynur Azizova2
1Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkiye.
Craniocervical junction involvement is common in inflammatory arthritis, particularly rheumatoid arthritis (RA) and spondyloarthritis (SpA). The odontoid process is frequently affected, highlighting its role in these conditions.
Area of Science:
- Rheumatology
- Radiology
- Orthopedics
Background:
- Inflammatory arthritis, including rheumatoid arthritis (RA), spondyloarthritis (SpA), and psoriatic arthritis (PsA), can affect the craniocervical junction (CCJ).
- Understanding the patterns of CCJ involvement is crucial for managing these conditions.
Purpose of the Study:
- To define and compare the types of CCJ involvement in RA, SpA, and PsA.
- To contrast CCJ involvement in these inflammatory arthritides with patients lacking inflammatory conditions.
Main Methods:
- Retrospective analysis of cervical CT or MRI scans from 2010-2020.
- Inclusion of patients diagnosed with RA, SpA, or PsA, and a control group without inflammatory arthritis.
- Reevaluation of CCJ involvements by an experienced radiologist.
Main Results:
- CCJ involvement was significantly more prevalent in RA (49.5%), SpA (26.5%), and PsA (18.2%) compared to controls (5.1%).
- The odontoid process was a primary site of involvement, especially in RA (33.8%).
- While vertical subluxation occurred, brainstem compression was rare.
Conclusions:
- Craniocervical junction involvement is a frequent finding in patients with inflammatory arthritis, notably RA and SpA.
- The odontoid process represents a key anatomical target for inflammation in these conditions.
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