Asymptomatic Atlantoaxial Subluxation in Rheumatoid Arthritis
This cross-sectional study is conducted to determine the prevalence of asymptomatic cervical spine subluxation in rheumatoid arthritis patients by plain radiographs and its relation to demographic and clinical characteristics, disease activity measures and medications. 100 rheumatoid arthritis pati...
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Tehran University of Medical Sciences
2014-06-01
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doaj-5e5c90d08b2f479eaef316305ad43a442020-11-25T02:54:03ZengTehran University of Medical SciencesActa Medica Iranica0044-60251735-96942014-06-015264731Asymptomatic Atlantoaxial Subluxation in Rheumatoid ArthritisMohammadali Nazarinia0Reza Jalli1Eskandar Kamali Sarvestani2Siamak Farahangiz3Maryam Ataollahi4Shiraz Geriatric Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.Department of Radiology, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.Autoimmune Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.Department of Radiology, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.Shiraz Geriatric Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. This cross-sectional study is conducted to determine the prevalence of asymptomatic cervical spine subluxation in rheumatoid arthritis patients by plain radiographs and its relation to demographic and clinical characteristics, disease activity measures and medications. 100 rheumatoid arthritis patients (18 male and 82 female) were selected randomly, according to the American college of Rheumatology Criteria, who were under follow up in the rheumatology clinic. A complete history was taken, and physical examination has been done with focus on the cervical spine to determine their demographic data, disease duration, age of disease onset, drug history, swollen and tender joint counts, and ESR, Hb, CRP, RF levels. The disease activity of patients with rheumatoid arthritis was measured using the disease activity score 28. Radiographs of the cervical spine included lateral views taken in flexion, extension, neutral position of the neck and anterioposterior and odontoid projection view. Asymptomatic cervical spine subluxation was found in 17 of the 100 patients (17%). The prevalence of, anterior atlantoaxial subluxation, atlantoaxial impaction and subaxial subluxation was 10(10%), 5(5%) and 6(6%), respectively. Posterior subluxation was not detected. The only characteristic that showed meaningful relationship with cervical spine subluxation was CRP (P=0.036). Our results showed that patients with RA, who have cervical spine subluxation cannot be distinguished on the basis of symptoms. Cervical spine involvement is common and may be asymptomatic, indicating routine cervical spine imaging is needed in patients with RA. https://acta.tums.ac.ir/index.php/acta/article/view/4778Atlantoaxial impactionCervical spine subluxationSubaxial subluxationRheumatoid arthritis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Mohammadali Nazarinia Reza Jalli Eskandar Kamali Sarvestani Siamak Farahangiz Maryam Ataollahi |
spellingShingle |
Mohammadali Nazarinia Reza Jalli Eskandar Kamali Sarvestani Siamak Farahangiz Maryam Ataollahi Asymptomatic Atlantoaxial Subluxation in Rheumatoid Arthritis Acta Medica Iranica Atlantoaxial impaction Cervical spine subluxation Subaxial subluxation Rheumatoid arthritis |
author_facet |
Mohammadali Nazarinia Reza Jalli Eskandar Kamali Sarvestani Siamak Farahangiz Maryam Ataollahi |
author_sort |
Mohammadali Nazarinia |
title |
Asymptomatic Atlantoaxial Subluxation in Rheumatoid Arthritis |
title_short |
Asymptomatic Atlantoaxial Subluxation in Rheumatoid Arthritis |
title_full |
Asymptomatic Atlantoaxial Subluxation in Rheumatoid Arthritis |
title_fullStr |
Asymptomatic Atlantoaxial Subluxation in Rheumatoid Arthritis |
title_full_unstemmed |
Asymptomatic Atlantoaxial Subluxation in Rheumatoid Arthritis |
title_sort |
asymptomatic atlantoaxial subluxation in rheumatoid arthritis |
publisher |
Tehran University of Medical Sciences |
series |
Acta Medica Iranica |
issn |
0044-6025 1735-9694 |
publishDate |
2014-06-01 |
description |
This cross-sectional study is conducted to determine the prevalence of asymptomatic cervical spine subluxation in rheumatoid arthritis patients by plain radiographs and its relation to demographic and clinical characteristics, disease activity measures and medications. 100 rheumatoid arthritis patients (18 male and 82 female) were selected randomly, according to the American college of Rheumatology Criteria, who were under follow up in the rheumatology clinic. A complete history was taken, and physical examination has been done with focus on the cervical spine to determine their demographic data, disease duration, age of disease onset, drug history, swollen and tender joint counts, and ESR, Hb, CRP, RF levels. The disease activity of patients with rheumatoid arthritis was measured using the disease activity score 28. Radiographs of the cervical spine included lateral views taken in flexion, extension, neutral position of the neck and anterioposterior and odontoid projection view. Asymptomatic cervical spine subluxation was found in 17 of the 100 patients (17%). The prevalence of, anterior atlantoaxial subluxation, atlantoaxial impaction and subaxial subluxation was 10(10%), 5(5%) and 6(6%), respectively. Posterior subluxation was not detected. The only characteristic that showed meaningful relationship with cervical spine subluxation was CRP (P=0.036). Our results showed that patients with RA, who have cervical spine subluxation cannot be distinguished on the basis of symptoms. Cervical spine involvement is common and may be asymptomatic, indicating routine cervical spine imaging is needed in patients with RA.
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topic |
Atlantoaxial impaction Cervical spine subluxation Subaxial subluxation Rheumatoid arthritis |
url |
https://acta.tums.ac.ir/index.php/acta/article/view/4778 |
work_keys_str_mv |
AT mohammadalinazarinia asymptomaticatlantoaxialsubluxationinrheumatoidarthritis AT rezajalli asymptomaticatlantoaxialsubluxationinrheumatoidarthritis AT eskandarkamalisarvestani asymptomaticatlantoaxialsubluxationinrheumatoidarthritis AT siamakfarahangiz asymptomaticatlantoaxialsubluxationinrheumatoidarthritis AT maryamataollahi asymptomaticatlantoaxialsubluxationinrheumatoidarthritis |
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