[Cervical involvement in rheumatoid arthritis (author's transl)]

Area of Science:

• Rheumatology
• Radiology
• Orthopedics

Background:

• Rheumatoid arthritis (RA) is a chronic inflammatory disease.
• Cervical spine involvement is a known complication of RA.
• Radiological assessment is vital for managing RA complications.

Purpose of the Study:

• To determine the prevalence of cervical spine lesions in rheumatoid arthritis patients.
• To highlight the radiological findings and clinical significance of cervical spine involvement in RA.
• To emphasize the importance of regular radiological surveillance of the cervical spine in RA patients.

Main Methods:

• Retrospective analysis of 577 rheumatoid arthritis patient records.
• Radiological examination of the cervical spine.
• Focus on specific radiological views, including lateral films with neck flexion.
• Measurement of atlanto-axial dislocation and assessment of other cervical spine lesions.

Main Results:

• Cervical spine lesions were identified in 28% (165/577) of rheumatoid arthritis patients.
• Atlanto-axial dislocation was the most common lesion, with some dislocations up to 10 mm.
• Other lesions included lateral mass involvement and odontoid process erosion/destruction.
• Neurological complications, including the risk of quadriplegia, were a significant concern despite minimal clinical signs in some cases.

Conclusions:

• Cervical spine involvement is a significant risk in rheumatoid arthritis.
• Routine radiological examination of the upper cervical spine (C1-C2) is necessary for early detection and management.
• Prompt surgical intervention, such as posterior occipital C1-C2 fixation, may be indicated in certain cases.