M. Kauppi et Mh. Neva, Sensitivity of lateral view cervical spine radiographs taken in the neutral position in atlantoaxial subluxation in rheumatic diseases, CLIN RHEUMA, 17(6), 1998, pp. 511-514
The value of lateral view cervical radiography in various positions of the
neck was assessed in patients with rheumatoid atlantoaxial subluxation (AAS
). We wanted to find out how much information is lost if only neutral posit
ion radiographs are used. The series consisted of 65 rheumatoid patients wi
th unstable AAS. Lateral view cervical spine radiographs were taken in the
neutral position and during flexion and extension. Neutral position radiogr
aphs would have failed to confirm the diagnosis of AAS in 31 cases (48%) an
d would have failed to record its true severity in 43 cases (66%); their di
agnostic sensitivity was 52%. The sensitivity of the neutral radiographs in
showing the reversibility of AAS was 48%. Routine cervical spine radiograp
hy of rheumatoid patients should include lateral view radiographs taken dur
ing flexion and extension. The result may be applied to magnetic resonance
imaging, which is usually performed in the neutral position.