INVOLVEMENT OF ATLANTOAXIAL JOINT IN RHEUMATOID-ARTHRITIS - RARE OR FREQUENT

The authors studied the incidence of atlanto-axial joint involvement b y conventional radiography and CT in 183 patients with classical or de finite rheumatoid arthritis (RA). In determining lesions the significa nce of factors such as age, sex, duration and severity of the disease was evaluated. Atlanto-axial subluxations turned out to be quite frequ ent (30%) in the series of patients examined and were directly correla ted with age, duration and stage of the disease, and extra-articular m anifestations. Clinical symptoms were evident in only 70.9% of cases, confirming the correlation reported by other authors between clinical manifestations and radiologically observed lesions. Traditional radiog raphy performed in the dynamic position revealed a prevalence of anter ior subluxation, whereas CT gave a precise indication of the entity an d type of atlanto-axial lesion. In conclusion, the authors confirm the importance of such investigations in all patients with RA, even those without evident clinical manifestations. They also emphasize the nece ssity of periodic monitoring in view of the possible risk of mortality in these patients.