Rheumatoid arthritis. Radiological changes in the cervical spine

OBJECTIVE: To describe the radiographic cervical spine changes in rheumatoid arthritis patients.

METHODS: Forty-nine patients (37 females and 12 males) diagnosed with rheumatoid arthritis at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia, between June 1998 and June 2000, were studied for their radiographic cervical spine changes. Their mean age at disease onset was 41.4 +/- 13.4 years (range of 18-73) and mean duration of the disease was 9.1 +/- 6.28 years (range of 2-34). Their demographic data including rheumatoid factor status was obtained. Standard conventional radiographs of cervical spine were obtained to study the cervical spine changes.

RESULTS: Cervical spine radiographic changes were found in 34 patients (27 females and 7 males), 10 had subluxation (7 with atlanto-axial subluxation, 2 with sub-axial subluxation, and one with lateral subluxation). No vertical impaction was seen. Erosion of odontoid process was seen in one patient. All were rheumatoid seropositive.

CONCLUSION: Cervical spine changes in patients with rheumatoid arthritis are common, in particular subluxation in the upper cervical spine. Our study showed somewhat lesser prevalence of these changes. These were clinically correlated with disease duration, female sex, and rheumatoid factor, but were not statistically significant.