Journal
AUTOIMMUNITY REVIEWS
Volume 13, Issue 12, Pages 1195-1202Publisher
ELSEVIER SCIENCE BV
DOI: 10.1016/j.autrev.2014.08.014
Keywords
Rheumatoid arthritis; Cervical spine; Cervical instabilities; Atlantoaxial subluxation; Subaxial subluxation
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Rheumatoid arthritis (RA) is a systemic chronic inflammatory disorder that can compromise the cervical spine in up to 80% of the cases. The most common radiological presentations of cervical involvement are atlantoaxial subluxation (AAS), cranial settling and subaxial subluxation (SAS). We performed a systematic review in the PubMed Database of articles published later 2005 to evaluate the prevalence, progression and risk factors for cervical spine involvement in RA patients. Articles were classified according to their level of evidence. Our literature review reported a wide range in the prevalence of cervical spine disease, probably explained by the different studied populations and disease characteristics. Uncontrolled RA is probably the main risk factor for developing a spinal instability. Adequate treatment with DMARD and BA can prevent development of cervical instabilities but did not avoid progression of a pre-existing injury. MRI is the best radiological method for diagnosis cervical spine involvement. MS is the most common form of RA. Long term radiological follow-up is necessary to diagnosis patients with late instabilities and monitoring progression of diagnosed injuries. (C) 2014 Elsevier B.V. All rights reserved.
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