Patterns of radiographic damage to cervical spine in polyarticular juvenile idiopathic arthritis patients presenting to tertiary care hospital in Pakistan

ABSTRACT

To see the radiographic cervical spine damage in polyarticular juvenile idiopathic arthritis [PJIA] coming to a tertiary care hospital in Islamabad, Pakistan. Cross-sectional descriptive study. The study was conducted in department of Rheumatology at Pakistan Institute of Medical Sciences from Jun 2013 to Dec 2013. A total of 50 patients of PJIA coming to Rheumatology Outpatient Department were recruited in the study after informed consent. Radiographs of cervical spine were performed for each patient in antero-posterior, lateral with flexion and extension and open-mouth views. Radiographs were reviewed for the following features loss of cervical lordosis, odontoid process erosion, anterior atlantoaxial subluxation, C1-C2 arthritis, atlantoaxial impaction, inflammation of disc, apophyseal joint arthritis, anterior ankylosis, apophyseal joint ankylosis, anterior and posterior subaxial subluxation and growth disturbances. Data was analysed using SPSS version 18. Out of the total 50 patients, 28 [56%] were females while 22 [44%] were males. The mean duration of pJIA was 5.54 +/- 3.28 years. Radiological cervical spine involvement was seen in 52% patients. The most common structural lesions were anterior atlantoaxial subluxation [30%], C1-C2 arthritis [22%] erosion of the odontoid process [18%], and apophyseal joint arthritis [16%]. Loss of cervical lordosis was found in 7 [14%] patients. There was no growth disturbances observed in vertebra. Cervical spine involvement is common in patients of PJIA. It is mostly asymptomatic, so routine cervical spine radiographs in all patients suffering from PJIA is recommended