Abstract:
We analyzed the CT appearances of degenerative
change in the atlanto-odontoid joint (AOJ) in patients
with rheumatoid arthritis (RA) and evaluated the
effect of these changes on atlanto-axial joint (AAJ)
rotation by dynamic CT. This revealed that 9 patients
(24%) treated with methotrexate had degenerative features
in the AOJ. The ratio of AAJ rotation to the total
rotation of the cervical spine was significantly higher in
normal subjects (54±3%) than in patients (38±12%).
The degree of AAJ rotation was significantly lower in
the patient group with degenerative features in the AOJ
(20.9±8.4) than in patients without degenerative features
(28.5±7.4). RA patients with a history of longstanding
disease and treatment with antirheumatic drugs
may develop AO OA. Although secondary OA was described
as healing phenomena in the joints of RA patients,
it can limit rotation in the AAJ and cause
suboccipital neck pain. A regular check-up of the AAJ
and AOJ by means of dynamic CT in all RA patients is
proposed to avoid possible antirheumatic drug complications.
