Assessment of cervical spine involvement in children with juvenile idiopathic arthritis: Clinical and x-ray findings

Abstract

Background: Juvenile idiopathic arthritis (JIA) is a heterogeneous group of inflammatory arthritis of unknown etiology in children with impending risk of impaired joint function. It is defied by the presence of at least one inflamed joint persisting 6 weeks with the onset before 16 years of age. The aim of this study was to determine the extent and pattern of cervical spine involvement in children with JIA using plain radiography. Methods: This study was carried on 50 JIA patients together with 20 age and sex matched apparently healthy volunteers representing a control group. Patients were subjected to history taking , full clinical examination, disease activity was measured using Juvenile Arthritis Disease Activity Score-27(JADAS-27) and X-ray was done to assess cervical spine involvement and Atlanto-Dens interval (the distance between anterior arch of atlas and the dens of axis) (ADI) was measured. Results: Cervical curve was straightened in 60% of patients' group. Intervertebral discs, retropharyngeal spaces, Spinolaminar line alignment and ADI measurements were normal in all cases. JIA patients of polyarticular type, had a higher incidence of neck pain and neck stiffness (P value = 0.798). There were no statistical significant difference regarding ADI measurements in JIA patients suffering from neck pain and neck stiffness (P value = 0.984). Conclusion: Neck pain & stiffness were more frequent in Polyarticular JIA patients than oligo articular or systemic onset type. No radiological abnormalities were detected between different types of JIA.