Background Involment of the cervical spine in patients with RA is particulary important for the injury of the neurogical structures.
Objectives The main aim of the present study was to determine the predisposing factors in the development of lesions of the cervical spine by magnetic resonance imaging (MRI) in patients with rheumatoid arthritis.
Methods The study was conducted on 21 patients with definite rheumatoid arthritis (ACR criteria, 2010). Disease duration, age of onset, disease activity for 28 joint indices score (DAS-28), serology (RF and ACPA) were recorded. All patients underwent an MRI examination of the cervical spine as well as hands and feet X-ray examination. Bone oedema, MRI bone erosions, presence of pannus anterior and posterior atlantodental intervals were identifided. The Simple Erosion Narrowing Score (SENS) was applied to assess the number of eroded joints and the number of narrowed joints for hands and feet.
Results In 6/21 (28.6%) cases MRI found signs indicative of lesion of the cervical spine. Presence of erosions was detected in 6/21; bone oedema – in 4/21; pannus – in 3/21; atlantoaxial subluxatiuon - in 3/21 patients. In 15/21 (71.4%) patients (comparison group) cervical spine injuries were not detected.
There were no relationships between the detection of lesions of the cervical spine and age of onset, disease activity at the time of examination, evaluation of cervical rotation, serology.Duration of RA (13.9±7.8) in the group of the patients with lesions of the cervical spine exceed the duration of the disease among patients of comparison group (7.8±5.8), but not significantly: p=0.09. The SENS score was significantly higher in patients with RA and damage to the cervical spine than in the comparison group (52.5±27.9 and 21.0±11.8 respectively; p=0,016). As well the number of eroded joints for hands and feet showed higher score compared with patients without identified of spine lesion (25.8±16.7 and 9.87±7.7 respectively; p=0,038).
Conclusions Our results indicate that clinical criteria are not sufficient to suggest damage in the cervical spine in patients with RA. While changes in the joints of hands and feet revealed by X-ray, more the number of eroded joints, may be predictive factor for the development of lesions in the cervical region.
Disclosure of Interest None Declared