Skip to main content

Advertisement

SpringerLink
Log in

Update on imaging of the cervical spine in rheumatoid arthritis

  • Review Article
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

Rheumatoid arthritis is a multisystem, autoimmune, inflammatory disorder with numerous musculoskeletal manifestations. Involvement of the cervical spine is common and may result in severe complications due to synovitis, erosions, pannus formation, spinal instability and ankylosis. The purpose of this article is to review the current role of imaging in the rheumatoid spine, with emphasis on radiographs and MRI.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12
Fig. 13
Fig. 14
Fig. 15
Fig. 16
Fig. 17
Fig. 18
Fig. 19

Similar content being viewed by others

References

  1. McInnes IB, Schett G. Pathogenetic insights from the treatment of rheumatoid arthritis. Lancet. 2017;389(10086):2328–37.

    Article  CAS  PubMed  Google Scholar 

  2. Hunter TM, Boytsov NN, Zhang X, Schroeder K, Michaud K, Araujo AB. Prevalence of rheumatoid arthritis in the United States adult population in healthcare claims databases, 2004–2014. Rheumatol Int. 2017;37(9):1551–7.

    Article  PubMed  Google Scholar 

  3. Drosos AA, Pelechas E, Voulgari PV. Radiological findings of the cervical spine in rheumatoid arthritis: what a rheumatologist should know. Curr Rheumatol Rep. 2020;22(6):19.

    Article  PubMed  Google Scholar 

  4. Smolen JS, Aletaha D. Rheumatoid arthritis therapy reappraisal: strategies, opportunities and challenges. Nat Rev Rheumatol. 2015;11(5):276–89.

    Article  PubMed  Google Scholar 

  5. Naranjo A, Carmona L, Gavrila D, Balsa A, Belmonte MA, Tena X, et al. Prevalence and associated factors of anterior atlantoaxial luxation in a nation-wide sample of rheumatoid arthritis patients. Clin Exp Rheumatol. 2004;22(4):427–32.

    CAS  PubMed  Google Scholar 

  6. Neva MH, Kauppi MJ, Kautiainen H, Luukkainen R, Hannonen P, Leirisalo-Repo M, et al. Combination drug therapy retards the development of rheumatoid atlantoaxial subluxations. Arthritis Rheum. 2000;43(11):2397–401.

    Article  CAS  PubMed  Google Scholar 

  7. Yurube T, Sumi M, Nishida K, Miyamoto H, Kohyama K, Matsubara T, et al. Incidence and aggravation of cervical spine instabilities in rheumatoid arthritis: a prospective minimum 5-year follow-up study of patients initially without cervical involvement. Spine (Phila Pa 1976). 2012 37(26):2136–44.

  8. Zikou AK, Alamanos Y, Argyropoulou MI, Tsifetaki N, Tsampoulas C, Voulgari PV, et al. Radiological cervical spine involvement in patients with rheumatoid arthritis: a cross sectional study. J Rheumatol. 2005;32(5):801–6.

    PubMed  Google Scholar 

  9. Gillick JL, Wainwright J, Das K. Rheumatoid arthritis and the cervical spine: a review on the role of surgery. Int J Rheumatol. 2015;2015:1–12.

    Article  Google Scholar 

  10. de Brito RS, Baldo DC, Andrade LEC. Clinical and pathophysiologic relevance of autoantibodies in rheumatoid arthritis. Adv Rheumatol. 2019;59(1):2.

    Article  Google Scholar 

  11. Volkov M, van Schie KA, van der Woude D. Autoantibodies and B cells: the ABC of rheumatoid arthritis pathophysiology. Immunol Rev. 2020;294(1):148–63.

    Article  CAS  PubMed  Google Scholar 

  12. Derksen VF a. M, Huizinga TWJ, van der Woude D. The role of autoantibodies in the pathophysiology of rheumatoid arthritis. Semin Immunopathol. 2017 39(4):437–46.

  13. Chen Z, Bozec A, Ramming A, Schett G. Anti-inflammatory and immune-regulatory cytokines in rheumatoid arthritis. Nat Rev Rheumatol. 2019;15(1):9–17.

    Article  CAS  PubMed  Google Scholar 

  14. Bogduk N. Functional anatomy of the spine. In: Handbook of clinical neurology. Elsevier; 2016. p. 675–88.

  15. Kim HJ, Nemani VM, Riew KD, Brasington R. Cervical spine disease in rheumatoid arthritis: incidence, manifestations, and therapy. Curr Rheumatol Rep. 2015;17(2):9.

    Article  PubMed  Google Scholar 

  16. Oláh C, Kardos Z, Kostyál L, Hodosi K, Tamási L, Bereczki D, et al. Assessment of cervical spine involvement in rheumatoid arthritis patients in the era of biologics: a real-life, cross-sectional MRI study. Rheumatol Int. 2020;40(6):915–21.

    Article  PubMed  Google Scholar 

  17. Joaquim AF, Ghizoni E, Tedeschi H, Appenzeller S, Riew KD, Md. Radiological evaluation of cervical spine involvement in rheumatoid arthritis. FOC. 2015 38(4):E4.

  18. Terashima Y, Yurube T, Hirata H, Sugiyama D, Sumi M, Hyogo Organization of Spinal Disorders. Predictive risk factors of cervical spine instabilities in rheumatoid arthritis: a prospective multicenter over 10-year cohort study. Spine (Phila Pa 1976). 2017 42(8):556–64.

  19. Laiho K, Kaarela K, Kauppi M. Cervical spine disorders in patients with rheumatoid arthritis and amyloidosis. Clin Rheumatol. 2002;21(3):227–30.

    Article  PubMed  Google Scholar 

  20. Cabot A, Becker A. The cervical spine in rheumatoid arthritis. Clin Orthop Relat Res. 1978;131:130–40.

    Google Scholar 

  21. Martel W. Pathogenesis of cervical discovertebral destruction in rheumatoid arthritis. Arthritis Rheum. 1977;20(6):1217–25.

    Article  CAS  PubMed  Google Scholar 

  22. Schils JP, Resnick D, Haghighi PN, Trudell D, Sartoris DJ. Pathogenesis of discovertebral and manubriosternal joint abnormalities in rheumatoid arthritis: a cadaveric study. J Rheumatol. 1989;16(3):291–7.

    CAS  PubMed  Google Scholar 

  23. Heinlen L, Humphrey MB. Skeletal complications of rheumatoid arthritis. Osteoporos Int. 2017;28(10):2801–12.

    Article  CAS  PubMed  Google Scholar 

  24. Mańczak M, Gasik R. Cervical spine instability in the course of rheumatoid arthritis – imaging methods. r. 2017;4:201–7.

  25. Krauss WE, Bledsoe JM, Clarke MJ, Nottmeier EW, Pichelmann MA. Rheumatoid arthritis of the craniovertebral junction. Neurosurgery. 2010;66(3 Suppl):83–95.

    Article  PubMed  Google Scholar 

  26. Zhang T, Pope J. Cervical spine involvement in rheumatoid arthritis over time: results from a meta-analysis. Arthritis Res Ther. 2015;17:148.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Riise T, Jacobsen BK, Gran JT. High mortality in patients with rheumatoid arthritis and atlantoaxial subluxation. J Rheumatol. 2001;28(11):2425–9.

    CAS  PubMed  Google Scholar 

  28. Nguyen HV, Ludwig SC, Silber J, Gelb DE, Anderson PA, Frank L, et al. Rheumatoid arthritis of the cervical spine. Spine J. 2004;4(3):329–34.

    Article  PubMed  Google Scholar 

  29. Wasserman BR, Moskovich R, Razi AE. Rheumatoid arthritis of the cervical spine–clinical considerations. Bull NYU Hosp Jt Dis. 2011;69(2):136–48.

    PubMed  Google Scholar 

  30. Paus AC, Steen H, Røislien J, Mowinckel P, Teigland J. High mortality rate in rheumatoid arthritis with subluxation of the cervical spine: a cohort study of operated and nonoperated patients. Spine (Phila Pa 1976). 2008 33(21):2278–83.

  31. Shoda N, Seichi A, Takeshita K, Chikuda H, Ono T, Oka H, et al. Sleep apnea in rheumatoid arthritis patients with occipitocervical lesions: the prevalence and associated radiographic features. Eur Spine J. 2009;18(6):905–10.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Menezes AH, VanGilder JC, Clark CR, el-Khoury G. Odontoid upward migration in rheumatoid arthritis. An analysis of 45 patients with ‘cranial settling’. J Neurosurg. 1985 63(4):500–9.

  33. Mallory GW, Halasz SR, Clarke MJ. Advances in the treatment of cervical rheumatoid: less surgery and less morbidity. World J Orthop. 2014;5(3):292–303.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Bodakçi E, Üsküdar Cansu D, Ertürk A, Çalişir C, Korkmaz C. Can neck pain be an initial symptom of rheumatoid arthritis? A case report and literature review. Rheumatol Int. 2018;38(5):925–31.

    Article  PubMed  Google Scholar 

  35. Pellicci PM, Ranawat CS, Tsairis P, Bryan WJ. A prospective study of the progression of rheumatoid arthritis of the cervical spine. J Bone Joint Surg Am. 1981;63(3):342–50.

    Article  CAS  PubMed  Google Scholar 

  36. Joaquim AF, Appenzeller S. Cervical spine involvement in rheumatoid arthritis — a systematic review. Autoimmun Rev. 2014;13(12):1195–202.

    Article  PubMed  Google Scholar 

  37. Mikulowski P, Wollheim FA, Rotmil P, Olsen I. Sudden death in rheumatoid arthritis with atlanto-axial dislocation. Acta Med Scand. 1975;198(6):445–51.

    CAS  PubMed  Google Scholar 

  38. Oshima K, Sakaura H, Iwasaki M, Nakura A, Fujii R, Yoshikawa H. Repeated vertebrobasilar thromboembolism in a patient with severe upper cervical instability because of rheumatoid arthritis. Spine J. 2011;11(2):e1-5.

    Article  PubMed  Google Scholar 

  39. Janssen I, Nouri A, Tessitore E, Meyer B. Cervical myelopathy in patients suffering from rheumatoid arthritis-a case series of 9 patients and a review of the literature. J Clin Med. 2020;9(3):E811.

    Article  PubMed  Google Scholar 

  40. Dreyer SJ, Boden SD. Natural history of rheumatoid arthritis of the cervical spine. Clin Orthop Relat Res. 1999;366:98–106.

    Article  Google Scholar 

  41. Shlobin NA, Dahdaleh NS. Cervical spine manifestations of rheumatoid arthritis: a review. Neurosurg Rev. 2021;44(4):1957–65.

    Article  PubMed  Google Scholar 

  42. Oda T, Fujiwara K, Yonenobu K, Azuma B, Ochi T. Natural course of cervical spine lesions in rheumatoid arthritis. Spine (Phila Pa 1976). 1995 20(10):1128–35.

  43. Kotecki M, Gasik R, Głuszko P, Sudoł-Szopińska I. Radiological evaluation of cervical spine involvement in rheumatoid arthritis: a cross-sectional retrospective study. JCM. 2021;10(19):4587.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. DeQuattro K, Imboden JB. Neurologic manifestations of rheumatoid arthritis. Rheumatic Disease Clinics of North America. 2017;43(4):561–71.

    Article  PubMed  Google Scholar 

  45. Yan W-J, Liu T-L, Zhou X-H, Chen X-S, Yuan W, Jia L-S. Clinical characteristics and diagnosis of rheumatoid arthritis of upper cervical spine: analysis of 71 cases. Zhonghua Yi Xue Za Zhi. 2008;88(13):901–4.

    PubMed  Google Scholar 

  46. Ahn YS, Woo SH, Kang SJ, Jung ST. Coronal malalignment of lower legs depending on the locations of the exostoses in patients with multiple hereditary exostoses. BMC Musculoskelet Disord. 2019;20(1):564.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Czerny C, Grampp S, Henk CB, Neuhold A, Stiskal M, Smolen J. Rheumatoid arthritis of the craniocervical region: assessment and characterization of inflammatory soft tissue proliferations with unenhanced and contrast-enhanced CT. Eur Radiol. 2000;10(9):1416–22.

    Article  CAS  PubMed  Google Scholar 

  48. Younes M, Belghali S, Kriâa S, Zrour S, Bejia I, Touzi M, et al. Compared imaging of the rheumatoid cervical spine: prevalence study and associated factors. Joint Bone Spine. 2009;76(4):361–8.

    Article  PubMed  Google Scholar 

  49. Sugita S, Chikuda H, Kadono Y, Ohtsu H, Takeshita K, Nishino J, et al. Clinical characteristics of rheumatoid arthritis patients undergoing cervical spine surgery: an analysis of National Database of Rheumatic Diseases in Japan. BMC Musculoskelet Disord. 2014;15:203.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  50. Zoli A, Priolo F, Galossi A, Altomonte L, Di Gregorio F, Cerase A, et al. Craniocervical junction involvement in rheumatoid arthritis: a clinical and radiological study. J Rheumatol. 2000;27(5):1178–82.

    CAS  PubMed  Google Scholar 

  51. Colebatch AN, Edwards CJ, Østergaard M, van der Heijde D, Balint PV, D’Agostino M-A, et al. EULAR recommendations for the use of imaging of the joints in the clinical management of rheumatoid arthritis. Ann Rheum Dis. 2013;72(6):804–14.

    Article  PubMed  Google Scholar 

  52. Dvorak J, Grob D, Baumgartner H, Gschwend N, Grauer W, Larsson S. Functional evaluation of the spinal cord by magnetic resonance imaging in patients with rheumatoid arthritis and instability of upper cervical spine. Spine (Phila Pa 1976). 1989 14(10):1057–64.

  53. Stiskal MA, Neuhold A, Szolar DH, Saeed M, Czerny C, Leeb B, et al. Rheumatoid arthritis of the craniocervical region by MR imaging: detection and characterization. AJR Am J Roentgenol. 1995;165(3):585–92.

    Article  CAS  PubMed  Google Scholar 

  54. Larsson EM, Holtås S, Zygmunt S. Pre- and postoperative MR imaging of the craniocervical junction in rheumatoid arthritis. AJR Am J Roentgenol. 1989;152(3):561–6.

    Article  CAS  PubMed  Google Scholar 

  55. Shi J, Ermann J, Weissman BN, Smith SE, Mandell JC. Thinking beyond pannus: a review of retro-odontoid pseudotumor due to rheumatoid and non-rheumatoid etiologies. Skeletal Radiol. 2019;48(10):1511–23.

    Article  PubMed  Google Scholar 

  56. Sommer OJ, Kladosek A, Weiler V, Czembirek H, Boeck M, Stiskal M. Rheumatoid arthritis: a practical guide to state-of-the-art imaging, image interpretation, and clinical implications. Radiographics. 2005;25(2):381–98.

    Article  PubMed  Google Scholar 

  57. Reijnierse M, Breedveld FC, Kroon HM, Hansen B, Pope TL, Bloem JL. Are magnetic resonance flexion views useful in evaluating the cervical spine of patients with rheumatoid arthritis? Skeletal Radiol. 2000;29(2):85–9.

    Article  CAS  PubMed  Google Scholar 

  58. Sudoł-Szopińska I, Jans L, Teh J. Rheumatoid arthritis: what do MRI and ultrasound show. J Ultrason. 2017;17(68):5–16.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Mańczak M, Pracoń G, Sudoł-Szopińska I, Gasik R. Apparent diffusion coefficient as an indicator of spinal cord compression due to anterior atlanto-axial subluxation in rheumatoid arthritis patients. Eur Spine J. 2019;28(10):2352–8.

    Article  PubMed  Google Scholar 

  60. Blom M, Creemers MCW, Kievit W, Lemmens J a. M, van Riel PLCM. Long-term follow-up of the cervical spine with conventional radiographs in patients with rheumatoid arthritis. Scand J Rheumatol. 2013;42(4):281–8.

  61. Boden SD, Dodge LD, Bohlman HH, Rechtine GR. Rheumatoid arthritis of the cervical spine. A long-term analysis with predictors of paralysis and recovery. J Bone Joint Surg Am. 1993 75(9):1282–97.

  62. Lustrin ES, Karakas SP, Ortiz AO, Cinnamon J, Castillo M, Vaheesan K, et al. Pediatric cervical spine: normal anatomy, variants, and trauma. Radiographics. 2003;23(3):539–60.

    Article  PubMed  Google Scholar 

  63. Mathews JA. Atlanto-axial subluxation in rheumatoid arthritis. A 5-year follow-up study. Ann Rheum Dis. 1974 33(6):526–31.

  64. Rana NA. Natural history of atlanto-axial subluxation in rheumatoid arthritis. Spine (Phila Pa 1976). 1989 14(10):1054–6.

  65. Yoshida G, Kamiya M, Yukawa Y, Kanemura T, Imagama S, Matsuyama Y, et al. Rheumatoid vertical and subaxial subluxation can be prevented by atlantoaxial posterior screw fixation. Eur Spine J. 2012;21(12):2498–505.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Paimela L, Laasonen L, Kankaanpää E, Leirisalo-Repo M. Progression of cervical spine changes in patients with early rheumatoid arthritis. J Rheumatol. 1997;24(7):1280–4.

    CAS  PubMed  Google Scholar 

  67. Fujiwara K, Owaki H, Fujimoto M, Yonenobu K, Ochi T. A long-term follow-up study of cervical lesions in rheumatoid arthritis. J Spinal Disord. 2000;13(6):519–26.

    Article  CAS  PubMed  Google Scholar 

  68. White AA, Johnson RM, Panjabi MM, Southwick WO. Biomechanical analysis of clinical stability in the cervical spine. Clin Orthop Relat Res. 1975;109:85–96.

    Article  Google Scholar 

  69. Wollowick AL, Casden AM, Kuflik PL, Neuwirth MJ. Rheumatoid arthritis in the cervical spine: what you need to know. Am J Orthop (Belle Mead NJ). 2007;36(8):400–6.

    Google Scholar 

  70. Yonezawa T, Tsuji H, Matsui H, Hirano N. Subaxial lesions in rheumatoid arthritis. Radiographic factors suggestive of lower cervical myelopathy. Spine (Phila Pa 1976). 1995 20(2):208–15.

  71. Ito H, Neo M, Sakamoto T, Fujibayashi S, Yoshitomi H, Nakamura T. Subaxial subluxation after atlantoaxial transarticular screw fixation in rheumatoid patients. Eur Spine J. 2009;18(6):869–76.

    Article  PubMed  PubMed Central  Google Scholar 

  72. Kraus DR, Peppelman WC, Agarwal AK, DeLeeuw HW, Donaldson WF. Incidence of subaxial subluxation in patients with generalized rheumatoid arthritis who have had previous occipital cervical fusions. Spine (Phila Pa 1976). 1991 16(10 Suppl):S486–489.

  73. Kurogochi D, Takahashi J, Uehara M, Ikegami S, Kuraishi S, Futatsugi T, et al. Ten-year results of reconstruction for rheumatoid cervical spine lesions and occurrence factor of subaxial subluxation. Asian Spine J. 2019;13(5):730–7.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Casey ATH, Crockard HA, Pringle J, O’Brien MF, Stevens JM. Rheumatoid arthritis of the cervical spine: current techniques for management. Orthop Clin North Am. 2002;33(2):291–309.

    Article  PubMed  Google Scholar 

  75. Fletcher DE, Rowley KA. The radiological features of rheumatoid arthritis. Br J Radiol. 1952;25(294):282–95.

    Article  CAS  PubMed  Google Scholar 

  76. Kaye JJ, Callahan LF, Nance EP, Brooks R, Pincus T. Bony ankylosis in rheumatoid arthritis. Associations with longer duration and greater severity of disease. Invest Radiol. 1987;22(4):303–9.

    Article  CAS  PubMed  Google Scholar 

  77. Iizuka H, Nishinome M, Sorimachi Y, Ara T, Nakajima T, Iizuka Y, et al. The characteristics of bony ankylosis of the facet joint of the upper cervical spine in rheumatoid arthritis patients. Eur Spine J. 2009;18(8):1130–4.

    Article  PubMed  PubMed Central  Google Scholar 

  78. Eulderink F, Meijers KA. Pathology of the cervical spine in rheumatoid arthritis: a controlled study of 44 spines. J Pathol. 1976;120(2):91–108.

    Article  CAS  PubMed  Google Scholar 

  79. Kauppi M, Hakala M. Prevalence of cervical spine subluxations and dislocations in a community-based rheumatoid arthritis population. Scand J Rheumatol. 1994;23(3):133–6.

    Article  CAS  PubMed  Google Scholar 

  80. Santavirta S, Sandelin J, Slätis P. Posterior atlanto-axial subluxation in rheumatoid arthritis. Acta Orthop Scand. 1985;56(4):298–301.

    Article  CAS  PubMed  Google Scholar 

  81. Verjaal A, Harder NC. Backward luxation of the atlas: report of a case. Acta Radiol Diagn (Stockh). 1965;3:173–6.

    Article  CAS  Google Scholar 

  82. Isdale IC, Corrigan AB. Backward luxation of the atlas. Two cases of an uncommon condition. Ann Rheum Dis. 1970;29(1):6–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  83. Frigaard E. Posterior atlanto-axial subluxation in rheumatoid arthritis. Scand J Rheumatol. 1978;7(2):65–8.

    Article  CAS  PubMed  Google Scholar 

  84. Teigland J, Magnæs B. Rheumatoid backward dislocation of the atlas with compression of the spinal cord. Scand J Rheumatol. 1980;9(4):253–6.

    Article  CAS  PubMed  Google Scholar 

  85. Ornilla E, Ansell BM, Swannell AJ. Cervical spine involvement in patients with chronic arthritis undergoing orthopaedic surgery. Ann Rheum Dis. 1972;31(5):364–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  86. Rasker JJ, Cosh JA. Radiological study of cervical spine and hand in patients with rheumatoid arthritis of 15 years’ duration: an assessment of the effects of corticosteroid treatment. Ann Rheum Dis. 1978;37(6):529–35.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  87. Bland JH, Davis PH, London MG, Vanbuskirk FW, Duarte CG. Rheumatoid arthritis of cervical spine. Arch Intern Med. 1963;112:892–8.

    Article  CAS  PubMed  Google Scholar 

  88. Kauppi M. A method for classification of the posterior atlanto-axial subluxation. Clin Rheumatol. 1994;13(3):492–5.

    Article  CAS  PubMed  Google Scholar 

  89. Byrne RP, Woodward HW. Occult fracture of the odontoid process: report of case. J Oral Surg. 1972;30(9):684–6.

    CAS  PubMed  Google Scholar 

  90. Higgins GL. Delayed subluxation of an occult traumatic odontoid fracture in an elderly patient. Acad Emerg Med. 1995;2(7):634–8.

    Article  PubMed  Google Scholar 

  91. Ballard WT, Clark CR. Increased atlanto-axial instability secondary to an atraumatic fracture of the odontoid process in a patient who had rheumatoid arthritis. A case report. J Bone Joint Surg Am. 1995;77(8):1245–8.

    Article  CAS  PubMed  Google Scholar 

  92. Lewandrowski K-U, Park PP, Baron JM, Curtin SL. Atraumatic odontoid fractures in patients with rheumatoid arthritis. Spine J. 2006;6(5):529–33.

    Article  PubMed  Google Scholar 

  93. Findikoglu G, Ardic F, Akkaya N, Sahin F, Sabir N, Cirak B. A case with rheumatod arthritis and atraumatic odontoid fracture: disappearence of bony landmarks. Int J Rheum Dis. 2018;21(11):2041–5.

    Article  PubMed  Google Scholar 

  94. Toyama Y, Hirabayashi K, Fujimura Y, Satomi K. Spontaneous fracture of the odontoid process in rheumatoid arthritis. Spine (Phila Pa 1976). 1992 17(10 Suppl):S436–441.

  95. Takahata M, Abumi K, Sudo H, Nagahama K, Iwasaki N. Cervical myelopathy due to atraumatic odontoid fracture in patients with rheumatoid arthritis: a case series. Mod Rheumatol. 2017;27(5):901–4.

    Article  PubMed  Google Scholar 

  96. Wright NM, Lauryssen C. Vertebral artery injury in C1–2 transarticular screw fixation: results of a survey of the AANS/CNS section on disorders of the spine and peripheral nerves. American Association of Neurological Surgeons/Congress of Neurological Surgeons. J Neurosurg. 1998;88(4):634–40.

    Article  CAS  PubMed  Google Scholar 

  97. Cho KH, Shin YS, Yoon SH, Kim SH, Ahn YH, Cho KG. Poor surgical technique in cervical plating leading to vertebral artery injury and brain stem infarction–case report. Surg Neurol. 2005;64(3):221–5.

    Article  PubMed  Google Scholar 

  98. Chen T-Y, Lin K-L, Ho H-H. Morphologic characteristics of atlantoaxial complex in rheumatoid arthritis and surgical consideration among Chinese. Spine (Phila Pa 1976). 2004 29(9):1000–4; discussion 1005.

  99. Loeb M, Bookman A, Mikulis D. Rheumatoid arthritis and vertebral artery occlusion: a case report with angiographic and magnetic resonance demonstration. J Rheumatol. 1993;20(8):1402–5.

    CAS  PubMed  Google Scholar 

  100. Takeshima Y, Matsuda R, Hironaka Y, Motoyama Y, Nakase H. Rheumatoid arthritis-induced lateral atlantoaxial subluxation with multiple vertebrobasilar infarctions. Spine (Phila Pa 1976). 2015 40(3):E186–189.

  101. Smolen JS, Landewé R, Bijlsma J, Burmester G, Chatzidionysiou K, Dougados M, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update. Ann Rheum Dis. 2017;76(6):960–77.

    Article  PubMed  Google Scholar 

  102. Smolen JS, Breedveld FC, Burmester GR, Bykerk V, Dougados M, Emery P, et al. Treating rheumatoid arthritis to target: 2014 update of the recommendations of an international task force. Ann Rheum Dis. 2016;75(1):3–15.

    Article  PubMed  Google Scholar 

  103. Kaito T, Hosono N, Ohshima S, Ohwaki H, Takenaka S, Fujiwara H, et al. Effect of biological agents on cervical spine lesions in rheumatoid arthritis. Spine (Phila Pa 1976). 2012 37(20):1742–6.

  104. Kauppi MJ, Neva MH, Laiho K, Kautiainen H, Luukkainen R, Karjalainen A, et al. Rheumatoid atlantoaxial subluxation can be prevented by intensive use of traditional disease modifying antirheumatic drugs. J Rheumatol. 2009;36(2):273–8.

    Article  PubMed  Google Scholar 

  105. Kaito T, Ohshima S, Fujiwara H, Makino T, Yonenobu K. Predictors for the progression of cervical lesion in rheumatoid arthritis under the treatment of biological agents. Spine (Phila Pa 1976). 2013 38(26):2258–63.

  106. Neo M. Treatment of upper cervical spine involvement in rheumatoid arthritis patients. Mod Rheumatol. 2008;18(4):327–35.

    Article  PubMed  Google Scholar 

  107. Wolfs JFC, Kloppenburg M, Fehlings MG, van Tulder MW, Boers M, Peul WC. Neurologic outcome of surgical and conservative treatment of rheumatoid cervical spine subluxation: a systematic review. Arthritis Rheum. 2009;61(12):1743–52.

    Article  PubMed  Google Scholar 

  108. Hamilton JD, Gordon MM, McInnes IB, Johnston RA, Madhok R, Capell HA. Improved medical and surgical management of cervical spine disease in patients with rheumatoid arthritis over 10 years. Ann Rheum Dis. 2000;59(6):434–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  109. Zenmyo M, Ijiri K, Sasaki H, Sakakima H, Taketomi E, Nagayoshi R, et al. Magnetic resonance angiography for vertebral artery evaluation in rheumatoid arthritis patients. Neurosurgery. 2010 66(6):1174–80; discussion 1180.

  110. Ostrowski RA, Takagishi T, Robinson J. Rheumatoid arthritis, spondyloarthropathies, and relapsing polychondritis. Handb Clin Neurol. 2014;119:449–61.

    Article  PubMed  Google Scholar 

  111. Reiter MF, Boden SD. Inflammatory disorders of the cervical spine. Spine (Phila Pa 1976). 1998 23(24):2755–66.

  112. Kochanski RB, Lombardi JM, Laratta JL, Lehman RA, O’Toole JE. Image-guided navigation and robotics in spine surgery. Neurosurgery. 2019;84(6):1179–89.

    Article  PubMed  Google Scholar 

  113. Sangondimath G, Mallepally AR, Marathe N, Mak K-C. Suman Salimath null. Degenerative cervical myelopathy: recent updates and future directions. J Clin Orthop Trauma. 2020;11(5):822–9.

    Article  PubMed  PubMed Central  Google Scholar 

  114. Samanta R, Shoukrey K, Griffiths R. Rheumatoid arthritis and anaesthesia. Anaesthesia. 2011;66(12):1146–59.

    Article  CAS  PubMed  Google Scholar 

  115. Fombon FN, Thompson JP. Anaesthesia for the adult patient with rheumatoid arthritis. Continuing Education in Anaesthesia Critical Care & Pain. 2006;6(6):235–9.

    Article  Google Scholar 

  116. Howe CR, Gardner GC, Kadel NJ. Perioperative medication management for the patient with rheumatoid arthritis. J Am Acad Orthop Surg. 2006;14(9):544–51.

    Article  PubMed  Google Scholar 

  117. Clynes MA, Jameson K, Prieto-Alhambra D, Harvey NC, Cooper C, Dennison EM. Impact of rheumatoid arthritis and its management on falls, fracture and bone mineral density in UK Biobank. Front Endocrinol (Lausanne). 2019;10:817.

    Article  Google Scholar 

  118. Kourtopoulos H, von Essen C. Stabilization of the unstable upper cervical spine in rheumatoid arthritis. Acta Neurochir (Wien). 1988;91(3–4):113–5.

    Article  CAS  Google Scholar 

  119. Sunahara N, Matsunaga S, Mori T, Ijiri K, Sakou T. Clinical course of conservatively managed rheumatoid arthritis patients with myelopathy. Spine (Phila Pa 1976). 1997 22(22):2603–7; discussion 2608.

  120. Chen Q, Brahimaj BC, Khanna R, Kerolus MG, Tan LA, David BT, et al. Posterior atlantoaxial fusion: a comprehensive review of surgical techniques and relevant vascular anomalies. J Spine Surg. 2020;6(1):164–80.

    Article  PubMed  PubMed Central  Google Scholar 

  121. Miyamoto H, Sumi M, Uno K. Outcome of surgery for rheumatoid cervical spine at one institute over three decades. Spine J. 2013;13(11):1477–84.

    Article  PubMed  Google Scholar 

  122. Grob D, Würsch R, Grauer W, Sturzenegger J, Dvorak J. Atlantoaxial fusion and retrodental pannus in rheumatoid arthritis. Spine (Phila Pa 1976). 1997 22(14):1580–3; discussion 1584.

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, London North West University Healthcare NHS Trust, Harrow, UK

    Mostafa Ellatif & Ban Sharif

  2. Department of Spinal Surgery, Royal National Orthopaedic Hospital, Stanmore, UK

    David Baxter

  3. Department of Radiology, Royal National Orthopaedic Hospital, Stanmore, UK

    Asif Saifuddin

Authors
  1. Mostafa Ellatif
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ban Sharif
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. David Baxter
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Asif Saifuddin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mostafa Ellatif.

Ethics declarations

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ellatif, M., Sharif, B., Baxter, D. et al. Update on imaging of the cervical spine in rheumatoid arthritis. Skeletal Radiol 51, 1535–1551 (2022). https://doi.org/10.1007/s00256-022-04012-w

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-022-04012-w

Keywords

Search

Navigation