Radiological Changes of Cervical Spine Associated with Rheumatoid Arthritis

Year 1983, Volume: 36 Issue: 4, 477 - 486, 31.12.1983

Nurben Süldür

Abstract

In this study 48 patients with RA were subjected to radiological examination with respect to alterations in their cervical spine. This was done with the examination of their radiograms taken in neutral, hyperextantion and hype'rflexion state laterally, as well as posterioanteriorly in open mouth position. When atlanto-odontoid space exceeded 2.5 mm with RA cases, these were regarded as subluxation. When the normal aligment of the vertabrae shifted 1 mm or more pcsteriorly or anteriorly, these were regarded as subaxial subluxation. In the end. the most frequently observed radiological changes with RA patients were respectively; bony demineralization, atlantoodontoid subluxation, osteophytic narrowing and erosions of the in- ‘tervertebral disc space, subaxial subluxation and fusion, degenerative changes and erosions in apophyseal joints. It was established that bony demineralization seen frequently in patients with RA was related with ages of the patients, and activity of the disease. Atlanto-odontoid subluxation most commonly seen in patients with long-standing disease. While narrowness and erosions with osteophytosis increased in proportion to the ages of the patients

Keywords

radiograms , subluxation , posterioanteriorly

Ethical Statement

-

Supporting Institution

-

Project Number

-

Thanks

-

SERVIKAL VERTEBRALARDA ROMATOID ARTRITE (RA) BAĞLI RADYOLOJIK DEGISIMLER

Abstract

Bu çalışmada 48 RA li hastanın servikal vertebralarındaki radyolojik değişimler, hastaların nötral pozisyonda, hiperfleksiyonda ve hiperekstansiyonda yan grafileri ile, ağız açık pozisyonda ön arka grafileri çekilerek incelendi. Atlanto-odontoid mesafe 2.5 mm yi geçen vakalar atlanto-odontoid subluksasyon, vertebraların arka kenarlarının alt alta dizilisinde 1 mm veya daha fazla kayma subaxial subluksasyon olarak kabul edildi. Sonugta RA li hastalarimizda en çok görülen radyolojik değişimlerin sirasiyla; osteoporoz, atlanto-odontoid subluksasyon, disko-vertebral kenarlarda osteofitli erozyonlar, vertebral disk araliginda osteofitli daralma, subaxial subluksasyon, apofiz eklemlerinde ankiloz, skleroz ve erozyon oldugu saptandi. Hastalarda siklikla gériilen osteoporozun hastalarin yaslar: ve hastaligin aktivitesi ile atlanto-odontoid subluksasyonun hastalik süresi ile, osteofitli darlık ve erozyonun ise hastalarin yas ile orantili olarak arttığı saptandi.

Keywords

osteofitli , radyolojik , hiperekstansiyonda

Ethical Statement

-

Supporting Institution

-

Project Number

-

Thanks

-

References

• Bland, J.H., Davis, P.H., and London, M.G. : Rheumatoid arthritis of the cervical spine. Arch. of Intern. Med. 112, 892-898, 1963.
• Conlon, P.W., Isdale, I.c and Rose, BS. : Rheumatoid arthritis of the cervical spine. Ann. of the Rheum. Dis. 25, 120-126, 1966.
• Davis, F.W., JR., and Markley, H.E. : Rheumatoid arthritis with death from medullary compression. Ann. Intern. Med. 35, 451 1951.
• Hinck, C.V., and Hopkins, E.C. : Measurement of the atlento-dental interval in the adult. Ann. J. Roent. Rad. Ther. Nuc. Med. 84, 945-51, 1960.
• Locke, GR., Gardner, JI., Van Epps, EF. : Atlas-dens interval (ADD in children, A study based on 200 normal cervical spines. Am. J. Roent. 97 : 135,1966.
• Martel, W. : Pathogenesis of cervical disco-vertebral destruction in rheumatoid arthritis. Arth. and Rheum. Vol. 20 No. 8, 1977.
• Martel, W. : The occipito-atlanto-axial joints in rheumatoid arthritis and ankylosing spondylitis. Amer. J. of Roent. 86, 223-240, 1961.
• Martel, W., and Abell, M.R. : Fatal atlanto-axial luxation in rheumatoid arthritis. Arth. and Rheum. 8, 224, 1963.
• Martel, W., Page, W.J. : Cervical vertebral erosions and subluxations in rheumatoid arthritis and ankylosing spondylitis. Arth. and Rheum. 3 : 546, 1960.
• Mathews, J.A. : Atlanto-axial subluxation in rheumatoid arthritis. Ann. of the Rheum. Dis. 28, 260-166, 1969.
• Meikle, J.A.K., and Wilkinson, M. : Rheumatoid involvement of the cervical spine. Ann. of the Rheum. Dis. 30, 154-161, 1971.
• Rasker, J.J., and Cosh, J.A. : Radiological study of cervical spine and hand in patients with rheumatoid arthritis of 15 years' duration : an assessment of the effocts of corticosteroid treatment. Ann. of the Rheum. Dis. 37, 520-535, 1973.
• Sharp, J., Purser, D.W,, and Lawrence, J.S. : Rheumatoid arthritis of the cervical spine in adult. Ann. of the Rheum. Dis. 17, 303-313, 1958.
• Smith, P, Benn, R.T, and Sharp, J. : Natural history of rheumatoid cervical luxations. Ann. of the Rheum. Dis. 31, 431-439, 1972.
• Stevens, J.C., Cartilidge, N.EF., Saunders, M., Appleby, A., Hall, M., and Shaw, D.A. : Atlanto-axial subluxation and cervical myelopathy in rheumatoid arthritis. Quant. J. of Med. 40, 391-408, 1971.
• Storey, G. : Changes in the cervical spine in rheumatoid arthritis with compres sin of the cord. Ann. Phys. Med. 4, 216, 1957-1958.