Spine xray3/30/2023 38 (4):E4.īodakçi E, Üsküdar Cansu D, Ertürk A, Çalişir C, Korkmaz C. Radiological evaluation of cervical spine involvement in rheumatoid arthritis. Joaquim AF, Ghizoni E, Tedeschi H, Appenzeller S, Riew KD. Angiogenesis as a potential treatment strategy for rheumatoid arthritis. Systematic review: targeted molecular imaging of angiogenesis and its mediators in rheumatoid arthritis. Khodadust F, Ezdoglian A, Steinz MM, et al. Predictive Risk Factors of Cervical Spine Instabilities in Rheumatoid Arthritis: A Prospective Multicenter Over 10-Year Cohort Study. Terashima Y, Yurube T, Hirata H, Sugiyama D, Sumi M, Hyogo Organization of Spinal Disorders. Cervical spine involvement risk factors in rheumatoid arthritis: a meta-analysis. The major role for CT and MRI is in the preoperative assessment. The need for further imaging by means of CT, MRI, or myelography may also be assessed during radiography. The mainstay of imaging the rheumatoid spine remains plain radiography to identify anterior atlantoaxial subluxation via the anterior or posterior atlantodental interval vertical subluxation via the McGregor method or Ranawat index diameter of the spinal canal and cervical height index. Flexion/extension views are necessary to assess the level of involvement and any evidence of instability. Posterior subluxation is seen in 7% of cases, and rotational subluxation is very rarely reported. In cases of AAS, anterior subluxation may be most common (70%), followed by lateral subluxation (20%). Synovial fibroblasts and activated immune cells are responsible for the production of inflammatory cytokines, which are believed to play a role in the development and progression of RA.Ĭlinically, cervical spine involvement in RA patients is reported to be mainly seen in 3 forms: atlantoaxial subluxation (AAS) (65%), superior odontoid migration (SOM) (20%), and subaxial subluxation (SAS) (15%). The risk factors for cervical spine involvement include frequency of peripheral joint erosion, rheumatoid factor (RF) positivity, use of corticosteroids, long RA duration, and markers of higher disease activity (erythrocyte sedimentation rate, C-reactive protein, and disease activity score).Įxtensive angiogenesis occurs in the synovial tissue, with interactions between vascular endothelial cells, fibroblasts, macrophages, and the extracellular matrix. The axial skeleton, with the exception of the cervical spine, is affected later and less frequently. Synovial inflammation causes cartilage destruction and bone erosion. The characteristic feature is persistent inflammatory synovitis usually involving peripheral joints in a symmetrical distribution. Rheumatoid arthritis (RA) is a chronic multisystemic disease of unknown cause.
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