Cervical spine involvement in functional class III rheumatoid arthritis

One hundred patients with Functional Class III Rheumatoid Arthritis were evaluated clinically and radiologically for cervical spine instability. Fifty patients had roentgenographic manifestation of such instability. Atlantoaxial subluxation was observed in 22, vertical settling in 9, and subaxial subluxation in 37 cases. In 18 patients, more than one type of instability was observed. Thirty-four patients were asymptomatic in the presence of radiologic instability. Neck pain was the most common complaint in the symptomatic group [16 patients]. Only one patient had long tract sign requiring cervical fusion