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Alterações radiográficas de coluna cervical em artrite reumatoide

Authors
  • Fernandez Alcala, Juan Marcelo
  • Douat, Diogo
  • Pinheiro, Diogo Lago
  • Kamei, Douglas Jun
  • dos Santos, Fábio Raimundo M.
  • Silva, Marilia B.
  • Skare, Thelma L.
Type
Published Article
Journal
Revista Brasileira de Reumatologia
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Jan 01, 2013
Accepted Date
Mar 14, 2013
Volume
53
Issue
5
Pages
388–393
Identifiers
DOI: 10.1590/S0482-50042013000500004
Source
Elsevier
Keywords
License
Unknown

Abstract

IntroductionThe involvement of the cervical spine is a common feature of rheumatoid arthritis (RA). ObjectiveTo study the prevalence of radiographic changes of the cervical spine in patients with RA and their association with clinical and serological profiles of the disease. MethodsWe analysed lateral (neutral position, hyperextension, hyperflexion) and transoral views of cervical spine radiographs from 80 individuals with RA to investigate the presence of atlanto-axial subluxation (AAS), basilar invagination (BI), and subaxial instability (SAI). Demographic, clinical (nodules, interstitial pneumonitis, secondary Sjögren's syndrome, medications etc.), and serologic (rheumatoid factor - RF, cyclic citrullinated peptide antibody – anti-CCP, and antinuclear factor - ANF) data were obtained from the clinical records. ResultsCervical spine misalignments were identified in 26/80 (32.5%) participants; AAS occurred in 12/80 (15%) participants, BI in 6/80 (7.5%), and SAI in 13/80 (32.5%). Odontoid erosions were identified in 16/80 (20.0%) participants. Cervical spine misalignment exhibited associations with age at onset and disease duration (P=0.03 and 0.02, respectively). No associations were identified between the cervical spine changes and the participants’ ethnicity or gender, presence of nodules, interstitial pneumonitis, secondary Sjögren's syndrome, RF, ANF, or anti-CCP. The participants with cervical spine misalignment exhibited higher frequencies of odontoid erosion (P=0.03). ConclusionsCervical spine misalignment was a common radiographic finding and occurred more frequently in participants with earlier onset and longer length of RA.

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