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The cervical spine in rheumatoid arthritis
Clinical Orthopaedics and Related Research
|March 1, 1978
Summary
Rheumatoid cervical spine disease affects nearly half of severe rheumatoid arthritis patients, often without symptoms. Early evaluation is crucial before anesthesia, regardless of clinical presentation.
Area of Science:
- Rheumatology
- Orthopedics
- Anesthesiology
Background:
- Rheumatoid arthritis (RA) frequently impacts the cervical spine.
- Cervical spine involvement in RA can lead to severe complications.
- Clinical presentation does not always correlate with disease severity.
Purpose of the Study:
- To characterize the spectrum of cervical spine involvement in severe rheumatoid arthritis.
- To assess the correlation between disease duration/activity and cervical spine disease.
- To emphasize the importance of pre-anesthetic cervical spine evaluation in RA patients.
Main Methods:
- Retrospective review of 53 patients with severe rheumatoid arthritis.
- Radiographic assessment of cervical spine involvement.
- Categorization of observed cervical spine pathologies.
Main Results:
- 43% of patients exhibited cervical spine involvement.
- Major categories included C1-C2 subluxation, serial subluxation, odontoid translocation/erosion, and apophyseal joint fusion.
- Miscellaneous findings included osteoporosis and disc space narrowing.
Conclusions:
- Cervical spine disease in RA is common and can be asymptomatic.
- Disease duration and activity are not universally predictive of cervical spine involvement.
- Pre-anesthetic cervical spine evaluation is recommended for all severe RA patients.