Magnetic resonance imaging of the craniovertebral junction in early rheumatoid arthritis

Carotti, Marina; Salaffi, Fausto; Carlo, Marco Di; Sessa, Francesco; Giovagnoni, Andrea

doi:10.1007/s00256-018-3055-9

Cited by 20 publications

(36 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These symptoms are caused by compression of the spinal cord and brain stem [ 39 ]. The cervical vertebrae C1 and C2 are the typical targets of the pathology and the involvement of the cervical spine can present various forms including erosions of the vertebral endplates, erosions of the spinous process, and changes in the apophyseal joint followed by osteoporosis [ 40 ]. These inflammatory lesions of the cervical spine, associated with frequent subluxations, occur within the first ten years after the diagnosis of RA, although many patients remain completely asymptomatic [ 41 ].…”

Section: Extra-articular Manifestations In Rheumatoid Arthritismentioning

confidence: 99%

Endothelial Dysfunction and Extra-Articular Neurological Manifestations in Rheumatoid Arthritis

et al. 2021

View full text Add to dashboard Cite

Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory autoimmune disease that affects about 1% of the global population, with a female–male ratio of 3:1. RA preferably affects the joints, with consequent joint swelling and deformities followed by ankylosis. However, evidence has accumulated showing that patients suffering from RA can also develop extra-articular manifestations, including cardiovascular disease states, neuropathies, and multiorgan dysfunction. In particular, peripheral nerve disorders showed a consistent impact in the course of the disease (prevalence about 20%) mostly associated to vasculitis of the nerve vessels leading to vascular ischemia, axonal degeneration, and neuronal demyelination. The pathophysiological basis of this RA-associated microvascular disease, which leads to impairment of assonal functionality, is still to be better clarified. However, endothelial dysfunction and alterations of the so-called brain-nerve barrier (BNB) seem to play a fundamental role. This review aims to assess the potential mechanisms underlying the impairment of endothelial cell functionality in the development of RA and to identify the role of dysfunctional endothelium as a causative mechanism of extra-articular manifestation of RA. On the other hand, the potential impact of lifestyle and nutritional interventions targeting the maintenance of endothelial cell integrity in patients with RA will be discussed as a potential option when approaching therapeutic solutions in the course of the disease.

show abstract

Section: Extra-articular Manifestations In Rheumatoid Arthritismentioning

confidence: 99%

Endothelial Dysfunction and Extra-Articular Neurological Manifestations in Rheumatoid Arthritis

et al. 2021

View full text Add to dashboard Cite

show abstract

“…4,5,6 The association between peripheral joint destruction and cervical spine subluxation in RA is known, 2 but only one previous study has correlated the Simple Erosion Narrowing Score (SENS) of both the hands and feet with the prevalence of cervical spine subluxation. 11 Our study is the first to correlate SENS of the hands only with cervical spine subluxation.…”

Section: Introductionmentioning

confidence: 80%

Simple Erosion Narrowing Score of the hands as a predictor of cervical spine subluxation in rheumatoid arthritis

Gous

Ally

Meyer

et al. 2020

South African Journal of Radiology

View full text Add to dashboard Cite

Background: Involvement of the cervical spine is common in patients with rheumatoid arthritis and can lead to devastating or even fatal consequences. Currently no guidelines exist as to whether radiographs of the cervical spine should be included in follow-up visits.Objectives: To determine whether the Simple Erosion Narrowing Score (SENS) of the hands correlate with the presence of cervical spine subluxation in patients with rheumatoid arthritis.Method: This was a retrospective, observational, cross-sectional study. A total of 56 rheumatoid arthritis patients with hand radiographs and lateral radiographs of the cervical spine were evaluated. The SENS of the hands and the presence of cervical spine subluxation were compared. The SENS of the hands was correlated with the prevalence of cervical spine subluxation, as was the erosion and joint space narrowing scores of the hands.Results: A correlation between the SENS of the hands and the prevalence of cervical spine subluxation was confirmed. A higher prevalence of cervical spine subluxation correlated with an increase in the SENS of the hands (p = 0.0002). The erosion and joint space narrowing scores of the hands also correlated with the prevalence of cervical spine subluxation (p = 0.0001).Conclusion: This study confirmed that a correlation exists between cervical spine subluxation, peripheral joint space erosions and joint space narrowing in patients with rheumatoid arthritis and SENS may therefore be used as a predictor of cervical spine disease.

show abstract

“…Atlantodental involvement is typically a late manifestation of RA [3]. However, patients with a worse disease activity score, high disease activity and erosive disease at baseline have a high risk of atlantoaxial involvement in early rheumatoid arthritis (ERA) (disease duration < 12 months) [1]. Affection of the small joints of the hand and foot, failure of antirheumatic therapies, intake of glucocorticoids, young age at diagnosis, level of CRP, female sex, and low BMI were identified as risk factors for cervical involvement [21,22].…”

Section: Discussionmentioning

confidence: 99%

“…Cervical myelopathy occurs in approximately 2.5% of patients suffering from rheumatoid arthritis (RA) for more than 14 years and is associated with notable morbidity and mortality [1]. In these cases, compression of the spinal cord and brain stem is typically caused by atlantoaxial instability (AAI) or atlantoaxial subluxation (AAS) with associated vertical migration of the dens of C2 and accompanying retrodental pannus formation [2].…”

Section: Introductionmentioning

confidence: 99%

Cervical Myelopathy in Patients Suffering from Rheumatoid Arthritis—A Case Series of 9 Patients and A Review of the Literature

Janssen

Nouri

Tessitore

et al. 2020

JCM

View full text Add to dashboard Cite

Cervical myelopathy occurs in approximately 2.5% of patients suffering from rheumatoid arthritis (RA) and is associated with notable morbidity and mortality. However, the surgical management of patients affected by cervical involvement in the setting of RA remains challenging and not well studied. To address this, we conducted a retrospective analysis of our clinical database between May 2007 and April 2017, and report on nine patients suffering from cervical myelopathy due to RA. We included patients treated surgically for cervical myelopathy on the basis of diagnosed RA. Clinical findings, treatment and outcome were assessed and reported. In addition, we conducted a narrative review of the literature. Four patients were male. Mean age was 64.8 ± 20.5 years. Underlying cervical pathology was anterior atlantoaxial instability (AAI) associated with retrodental pannus in four cases, anterior atlantoaxial subluxation (AAS) in two cases and basilar invagination in three cases. All patients received surgical treatment via posterior fixation, and in addition two of these cases were combined with a transnasal approach. Preoperative modified Japanese orthopaedic association scale (mJOA) improved from 12 ± 2.4 to 14.6 ± 1.89 at a mean follow-up at 18.8 ± 23.3 months (range 3-60 months) in five patients. In four patients, no follow up was available, and the mJOA of these patients at time of discharge was stable compared to the preoperative score. One patient died two days after surgery, where a pulmonary embolism was assumed to be the cause of mortality, and one patient sustained a temporary worsening of his neurological deficit postoperatively. Surgery is generally an effective treatment method in patients with inflammatory arthropathies of the cervical spine. Given the nature of the RA and potential instability, fixation in addition to cord decompression is generally required.

show abstract

Magnetic resonance imaging of the craniovertebral junction in early rheumatoid arthritis

Abstract: The craniovertebral junction is frequently involved in ERA patients. ACPA, high disease activity, and erosive disease at baseline are predictors of atlantoaxial involvement.

Cited by 20 publications

References 35 publications

Endothelial Dysfunction and Extra-Articular Neurological Manifestations in Rheumatoid Arthritis

Endothelial Dysfunction and Extra-Articular Neurological Manifestations in Rheumatoid Arthritis

Simple Erosion Narrowing Score of the hands as a predictor of cervical spine subluxation in rheumatoid arthritis

Cervical Myelopathy in Patients Suffering from Rheumatoid Arthritis—A Case Series of 9 Patients and A Review of the Literature

Contact Info

Product

Resources

About