Atlantoaxial (C1‐C2) facet joint osteoarthritis: a distinctive clinical syndrome

Halla, James T.; Hardin, Joe G.

doi:10.1002/art.1780300514

Cited by 70 publications

(31 citation statements)

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“…This decrease in atlantoaxial motion may well have been caused by atlanto-odontoid osteoarthritis, which was very evident from the elderly specimens, in contrast with the practical absence of degenerative changes of the lateral atlantoaxial joints. The above cadaveric findings are supported by the radiologic study performed by authors more recently [4,15,16].…”

Section: Discussionsupporting

confidence: 76%

“…This results in increased upper cervical spine injuries, as shown in the study of 225 cervical spine injuries in 149 consecutive patients 65 years and older, performed by Lomoschitz et al [7]. The incidence of degenerative changes in the lateral atlantoaxial joints in the normal elderly population varied from 4% to 18.2% in the literature [4,15]. The incidence of degenerative changes in the atlanto-odontoid joint in the normal population is quite high, with 42% in the seventh decade and 60.9% in the eighth decade, resulting in obliteration of atlanto-odontoid joint space [16].…”

Section: Discussionmentioning

confidence: 99%

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CT evaluation of the pattern of odontoid fractures in the elderly?relationship to upper cervical spine osteoarthritis

et al. 2004

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IntroductionAbove the age of 70 years, fracture of the odontoid process is the most common cervical spine injury [8,9]. Unlike the younger population, in whom odontoid process fractures are caused by high-energy injuries, in the elderly population they are frequently caused by low-energy trauma like falls [8,10]. The classification system detailed by Anderson and D' Alonzo for odontoid process fractures is Abstract Odontoid fractures are common in the elderly following minor falls. Almost all of them have osteoarthritis of the cervical spine below the axis vertebra. As a result, there is increased stress on the spared upper cervical spine, resulting in a higher incidence of injuries. As movement in the upper cervical spine involves participation of five joints, degeneration in any one particular joint may affect the biomechanics of loading of the upper cervical spine. We aimed to analyse the relationship of odontoid fractures to the pattern of upper cervical spine osteoarthritis in the elderly. We studied the CT-scan images of the cervical spine in 23 patients who were over the age of 70 years and had odontoid fractures. In each patient, the type of odontoid fracture and the characteristics of the degenerative changes in each joint were analysed. Twenty-one of 23 patients had Type -II odontoid fractures. The incidence of significant atlanto-odontoid degeneration in these individuals was very high (90.48%), with relative sparing of the lateral atlantoaxial joints. Osteoporosis was found in 13 of 23 patients at the dens-body junction and in seven of 23 patients at

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

CT evaluation of the pattern of odontoid fractures in the elderly?relationship to upper cervical spine osteoarthritis

et al. 2004

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“…We have previously reported similar patterns of Cl-C2 lateral facet joint disease in patients with RA (I ,9), ankylosing spondylitis (14), juvenile rheumatoid arthritis (14), and osteoarthritis (15), and in 1 patient with Reiter's syndrome (16), but the frequency and the severity of the involvement seem to be greatest in patients with RA. In another report, lateral mass collapse was identified in 10% of 126 hospitalized patients with RA (I), but lesser degrees of Cl-C2 lateral facet joint disease were not specifically addressed.…”

Section: Discussionmentioning

confidence: 58%

The spectrum of atlanto axial facet joint involvement in rheumatoid arthritis

Halla

Hardin

1990

Arthritis & Rheumatism

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Six hundred fifty outpatients with rheumatoid arthritis (RA) were evaluated and followed up during a 7‐year period. As part of their routine evaluation or because of neck‐shoulder girdle symptoms, 48% of the patients underwent routine cervical spine radiography. Sixty‐one RA patients (9% of the total population) had C1‐C2 involvement. Compared with the 589 patients with no evidence of C1‐C2 involvement, these 61 patients were significantly more likely to be younger, female, and seropositive, and they had significantly more nodules and erosions, as well as a longer disease duration. Based on radiographic evidence of C1‐C2 disease severity, 3 groups emerged. Group 1 (28 patients) had lateral mass collapse, group 2 (27 patients) had lateral facet joint sclerosis, erosion, or loss of joint space with no collapse, and group 3 (6 patients) had lateral subluxation with no bone or cartilage changes. Nine patients in group 1 had severe pain, and 25 had a nonreducible rotational tilt of the head. None of the patients in the other 2 groups had either of these signs or symptoms. Moreover, patients in group 1 were more likely to have other C1‐C2 or subaxial subluxations and were more likely to have myelopathy. C1‐C2 lateral facet joint involvement is common in RA, correlates with disease severity generally and specifically with that in the cervical spine, and, when severe, causes nonreducible rotational tilt of the patient's head.

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“…Atlanto-axial arthrosis was shown radiologically in 4% of patients with degenerative arthrosis of the spine (Halla and Hardin 1987). Posttraumatic changes also seem to play an important role (Ehrat et al 1996).…”

Section: Discussionmentioning

confidence: 98%

“…the lateral atlanto-axial joints (AAJ). Although they have been regarded as facet joints (Halla and Hardin 1987), they are unique in several ways. The axial joint surface is convex, articulating with a at surface on the atlas.…”

mentioning

confidence: 99%