H. Ostensen et al., 3-DIMENSIONAL CT EVALUATION OF OCCIPITOATLANTOAXIAL DISLOCATION IN RHEUMATOID-ARTHRITIS, Scandinavian journal of rheumatology, 27(5), 1998, pp. 352-356
Involvement of the upper cervical spine, with possible instability and
dislocation of the atlanto-axial-cervico-occipital joints in patients
with rheumatoid arthritis (RA), is routinely monitored with conventio
nal radiographs. As disease progresses severe interpretation problems
occur, especially when looking for cranial migration of the odontoid p
rocess. The aim of the present study was to evaluate whether three dim
ensional CT examination should be considered for such monitoring. Afte
r clinical and biochemical examination of 20 consecutive patients, dia
gnostic information about cranial migration of the odontoid process wa
s obtained by conventional radiograms and by three dimensional CT exam
ination. When using conventional radiographs the odontoid process and
the its relation to the skull base could be outlined in 8 of the 20 pa
tients, whereas all bony structures could be well demonstrated on the
CT examination and the degree of cranial migration into the foremen ma
gnum could be quantified. Three dimensional CT should be considered as
a reliable examination for monitoring RA patients with involvement of
the upper cervical spine and a possible cranial migration of the odon
toid process.