Craniovertebral junction MRI imaging revealed its involvement in early rheumatoid arthritis

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Craniovertebral junction MRI imaging revealed its involvement in early rheumatoid arthritis

Cervical spine inflammatory changes result as a consequence of intense chronic synovitis occurring in joints, progressing to erosion in bones, ligamentous laxity and finally radiological and clinical instability. The most frequent abnormalities are disk space narrowing, followed by decays in the odontoid process, atlantoaxial dislocation, and apophyseal joint involvement. The inclusion of atlantoaxial junction leading to atlantoaxial instability and bone erosions at the odontoid process is frequent and begins in 25% of early RA (ERA) patients, in particular, the subjects with active and erosive arthritis.

Marina Carotti et al. conducted a study to elucidate the involvement of atlantoaxial joint in patients with early rheumatoid arthritis and the risk profile for the individual patient. Fifty patients with consecutive ERA with a disease duration of about < 12 months were enrolled in the study. Magnetic resonance imaging (MRI) of the cervical spine and X-rays (cervical spine, hands, wrists, and feet) were performed. All the clinical, radiological, and biochemical variables were correlated with MRI features.

The findings of the study suggested the involvement of the craniovertebral junction in 12 patients. The patients with atlantoaxial synovitis demonstrated a significant increase in anti-citrullinated protein antibodies (ACPA) titer, a worse Disease Activity Score 44 joints (DAS44), a worse Health Assessment Questionnaire Disability Index (HAQ-DI), and a higher Simple Erosion Narrowing Score (SENS) as compared to the patients without cervical involvement. A clear association was found between atlantoaxial synovitis and ACPA, DAS44, and the presence of erosive disease was found.

It was deduced that the involvement of craniovertebral junction was frequent in ERA patients and the significant predictors of atlantoaxial participation were ACPA, high disease activity, and erosive disease at baseline.

Source

Skeletal Radiol

Link to the source:

https://www.ncbi.nlm.nih.gov/pubmed/30206675

Original title of the article

Magnetic resonance imaging of the craniovertebral junction in early rheumatoid arthritis

Authors:

Marina Carotti et al.

SearchTags: 
Exploratory, Rheumatoid arthritis, Cervical spine, Magnetic resonance imaging (MRI), Anti-citrullinated protein antibodies (ACPA) titer, Disease Activity Score 44 joints (DAS44), Health Assessment Questionnaire Disability Index (HAQ-DI), Simple Erosion Narrowing Score (SENS)
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