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The cervical spine in patients with psoriatic arthritis
  1. K Laiho,
  2. M Kauppi
  1. Rheumatism Foundation Hospital, Heinola, Finland
  1. Correspondence to:
    Dr K Laiho, Rheumatism Foundation Hospital, FIN-18120 Heinola, Finland;


Objective: To establish the incidence of clinically important inflammatory cervical spine abnormalities in radiographs of patients with psoriatic arthritis (PsA).

Methods: Patients were selected from a rheumatological outpatient clinic and one ward of the Rheumatism Foundation Hospital, Heinola, Finland, by examining 160 consecutive PsA cases. A total of 65 patients (38 women, 27 men) with PsA were identified who had cervical spine radiographs available. These were evaluated for inflammatory changes, and patient records studied for disease characteristics, laboratory and clinical findings.

Results: In 12 cases (18%) inflammatory cervical spine changes were seen in the cervical spine radiographs. The most frequently detected was apophysial joint ankylosis, seen in seven patients (11%). Anterior atlantoaxial subluxation (aAAS) was seen in five (8%) and atlantoaxial impaction in three (5%). In 20 of the 40 patients who had the rotational range of neck motion measured the measurement was ≤45° either to the left or the right side.

Conclusion: Inflammatory cervical spine changes were not commonly seen in radiographs of patients with PsA. Apophysial joint ankylosis and aAAS were detected most often. PsA may decrease the rotational range of neck motion significantly.

  • apophysial joint ankylosis
  • cervical spine
  • psoriatic arthritis
  • a (p)AAS, anterior (posterior) atlantoaxial subluxation
  • AAI, atlantoaxial impaction
  • CRP, C reactive protein
  • ESR, erythrocyte sedimentation rate
  • PsA, psoriatic arthritis
  • SAS, subaxial subluxation

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