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Clinical diagnosis of atlanto-axial joint involvement in patients with rheumatoid arthritis / 中华风湿病学杂志
Chinese Journal of Rheumatology ; (12): 237-240, 2017.
Article in Chinese | WPRIM | ID: wpr-512512
ABSTRACT
Objective To investigate the clinical manifestations,laboratory tests,and image modalities on rheumatoid arthritis (RA) accompanied with atlanto-axial joint involvement.Methods Sixty-four cases of RA accompanied with cervical vertebra involvement were divided into 2groups by lesion location.Twenty-two cases were RA accompanied with atlanto-axial joint involvement,while 42 cases were RA with cervical vertebra other than atlanto-axial joint involvement.The age,course,clinical manifestations and the lab results were compared between the two groups by t test,Chi-square test and Fisher's exact probability.The X-ray,CT and magnetic resonance imaging (MRI) for cervical vertebra were analyzed in RA with atlanto-axial joint involvement.Results Compared with non-atlantoaxial cervical group,the disease course [(15±10) years vs (8±9) years,t=3.030,P=0.004],upper cervical vertebra pain (73% vs 7%,x2=29.75,P<0.01),lower cervical vertebra pain (9% vs 40%,x2=6.813,P=0.009),cervical activity limitation (68% vs 14%,x2=19.023,P<0.01),upper cervical vertebra pressing pain (100% vs 7%,22=52.297,P<0.01),lower cervical vertebra pressing pain (9% vs 60%,x 2=15.056,P<0.01) and erythrocyte sedimentation rate (ESR) [(73±34) mm/1 h vs (53±37) am/1 h,t=2.039,P=0.046)] were significantly different in atlantoaxial joint lesions group.CT combined with MRI exams had high diagnostic..value in RA with atlanto-axial joint involvement.CT scan had the conformed diagnostic value.Sixteen cases were positive (73%) by MRI scan,while 3 cases (14%) by X-ray.Conclusion Timely CT scan and/or MRI scan for RA patients with neck pain in upper cervical vertebra,long disease course,cervical activity limitation and high ESR are helpful for early diagnosis of atlanto-axial joint involvement.

Full text: Available Index: WPRIM (Western Pacific) Type of study: Diagnostic study / Screening study Language: Chinese Journal: Chinese Journal of Rheumatology Year: 2017 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Type of study: Diagnostic study / Screening study Language: Chinese Journal: Chinese Journal of Rheumatology Year: 2017 Type: Article