LESSON OF THE MONTH

Cervical complications of rheumatoid arthritis

M J Kauppi¹, A Barcelos², J A P da Silva²

¹ Rheumatism Foundation Hospital, Pikijarventie 1, FI-18120 Heinola, Finland
² Reumatologia, Hospitais da Universidade, 3000-075 Coimbra, Portugal

Correspondence to:
Correspondence to:
Dr M J Kauppi
markku.kauppi@reuma.fi

Accepted 1 September 2004

Abbreviations: aAAS, anterior atlantoaxial subluxation; AAI, atlantoaxial impaction; DMARDs, disease modifying antirheumatic drugs; JIA, juvenile idiopathic arthritis; MCP, metacarpophalangeal; MRI, magnetic resonance imaging; NSAIDs, non-steroidal anti-inflammatory drugs; RA, rheumatoid arthritis; SAS, subaxial subluxation; S-K, Sakaguchi-Kauppi (method)

Keywords: atlantoaxial subluxation; cervical spine; radiographs; rheumatoid arthritis; treatment

The first 150 words of the full text of this article appear below.

A 47 year old housewife presented with a 3 year history of fleeting inflammatory pain and oedema affecting the small joints of the hands symmetrically. She had previously been given a diagnosis of rheumatoid arthritis (RA), and was receiving treatment with non-steroidal anti-inflammatory drugs (NSAIDs) and prednisolone (10 mg/day).

For the past year she had experienced inflammatory neck pain with a recurrent sense of heaviness and muscle weakness in the upper and lower limbs. Her symptoms were present, especially, during prolonged flexion and were relieved in a favourable posture.

Examination showed symmetrical arthritis and tenderness of wrist and metacarpophalangeal (MCP) joints in both hands. A reduction of about 30% was seen in the anterior and lateral flexion of the cervical spine. Neurological examination results were, however, normal.

Laboratory tests showed high acute phase response and negative rheumatoid factor. Radiographs of the hands and feet disclosed osteopenia but no erosions. Further . . . [Full text of this article]

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This article has been cited by other articles:

• KAUPPI, M. J., NEVA, M. H., LAIHO, K., KAUTIAINEN, H., LUUKKAINEN, R., KARJALAINEN, A., HANNONEN, P. J., LEIRISALO-REPO, M., KORPELA, M., ILVA, K., MOTTONEN, T., for the FIN-RACo Trial Group, (2009). Rheumatoid Atlantoaxial Subluxation Can Be Prevented by Intensive Use of Traditional Disease Modifying Antirheumatic Drugs. The Journal of Rheumatology 36: 273-278 [Abstract] [Full Text]  

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Cervical complications of rheumatoid arthritis

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