RESUMEN
Atlantolaxial subluxation is still the most eminent and helpful sign of rheumatoid arthritis of cervical spine, specially if correlated with disease activity parameters. Males are more susceptible to atlanto-axial subluxation and could occur early in disease even in asymptomatic cases. Plain x-ray in full flexion and extension and open mouth view provides a simple and reliable investigation for detection of atlanto-axial subluxation and other subaxial subluxation. It should be done early in the disease and it would be of great help to detect serious and unexpected complication in symptomatic and asymptomatic rheumatiod patients
RESUMEN
Patients with rheumatoid arthritis [RH A] frequently have involvement of the cervical spine; its effects ranging from minor restriction of movement and discomfort of major neurological disability. The present study is an evaluation of the radiological manifestation of rheumatoid disease of cervical spine and its correlation with various indicators of disease activity using plain X-ray. Fifty-five adult patients with [RH A] of both sexes constituted the material of this study. All patients were examinated clinically and radiologically in addition to laboratory investigations. More than one radiographic findings were seen in the same patient. Apophyseal joint affection and bony demineralization were seen frequently in rheumatoid patients. No significant differences were found between males and females for any of the common radiological changes. Significant differences existed between sero-positivity or negativity of the rheumatoid factor and radiological changes. There existed a relationship between oral corticosteroid therapy and the common radiographic findings especially osteoporosis, erosive changes, and atlanto axial subluxation. The percentages for agreement for the results of E.S.R. and Ritchie's index and radiological signs ranged from 71.4% to 100%. The more usefull criteria in diagnosis of rheumatoid involvement of cervical spine are combined clinical and radiological signs and it should be investigated and expected as early as possible especially with increased disease activities