Thursday, October 4, 2012

Cervical Spine Change in Rheumatoid Arthritis

60-80% of patients with rheumatoid arthritis have cervical spine involvement. Manifestations include:
  • atlantoaxial subluxation - do flexion/extension films, increased atlantodens interval
    • multilevel, "stepladder" subluxations may be seen
  • erosion of the dens
    • calcified pannus around the dens is NOT rheumatoid arthritis - usually CPPD
  • cranial settling - decreased distance from occiput to C2
    • due to facet joint erosions
  • spinous process erosions
  • erosions at the foramen of Luschka

Sommer OJ, Kladosek A, Weiler V, et al. Rheumatoid arthritis: a practical guide to state-of-the-art imaging, image interpretation, and clinical implications. Radiographics 2005;25:381-98.

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