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Atlanto-odontoid osteoarthritis in rheumatoid arthritis: dynamic CT findings

Atlanto-odontoid osteoarthritis in rheumatoid arthritis: dynamic CT findings We analyzed the CT appearances of degenerative change in the atlanto-odontoid joint (AOJ) in patients with rheumatoid arthritis (RA) and evaluated the effect of these changes on atlanto-axial joint (AAJ) rotation by dynamic CT. This revealed that 9 patients (24%) treated with methotrexate had degenerative features in the AOJ. The ratio of AAJ rotation to the total rotation of the cervical spine was significantly higher in normal subjects (54±3%) than in patients (38±12%). The degree of AAJ rotation was significantly lower in the patient group with degenerative features in the AOJ (20.9±8.4°) than in patients without degenerative features (28.5±7.4°). RA patients with a history of longstanding disease and treatment with antirheumatic drugs may develop AO OA. Although secondary OA was described as healing phenomena in the joints of RA patients, it can limit rotation in the AAJ and cause suboccipital neck pain. A regular check-up of the AAJ and AOJ by means of dynamic CT in all RA patients is proposed to avoid possible antirheumatic drug complications. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Clinical Rheumatology Springer Journals

Atlanto-odontoid osteoarthritis in rheumatoid arthritis: dynamic CT findings

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References (26)

Publisher
Springer Journals
Copyright
Copyright © 2004 by Clinical Rheumatology
Subject
Medicine & Public Health; Rheumatology
ISSN
0770-3198
eISSN
1434-9949
DOI
10.1007/s10067-004-0895-6
pmid
15459811
Publisher site
See Article on Publisher Site

Abstract

We analyzed the CT appearances of degenerative change in the atlanto-odontoid joint (AOJ) in patients with rheumatoid arthritis (RA) and evaluated the effect of these changes on atlanto-axial joint (AAJ) rotation by dynamic CT. This revealed that 9 patients (24%) treated with methotrexate had degenerative features in the AOJ. The ratio of AAJ rotation to the total rotation of the cervical spine was significantly higher in normal subjects (54±3%) than in patients (38±12%). The degree of AAJ rotation was significantly lower in the patient group with degenerative features in the AOJ (20.9±8.4°) than in patients without degenerative features (28.5±7.4°). RA patients with a history of longstanding disease and treatment with antirheumatic drugs may develop AO OA. Although secondary OA was described as healing phenomena in the joints of RA patients, it can limit rotation in the AAJ and cause suboccipital neck pain. A regular check-up of the AAJ and AOJ by means of dynamic CT in all RA patients is proposed to avoid possible antirheumatic drug complications.

Journal

Clinical RheumatologySpringer Journals

Published: Apr 20, 2004

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