| Autor: |
Amel Farhat, Chakib Kraeim, Achek Mohamed Amine El |
| Rok vydání: |
2019 |
| Předmět: |
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| Zdroj: |
Abstracts Accepted for Publication. |
| Popis: |
Background Cervical involvement in rheumatoid arthritis (RA) ranks third after erosive lesions of the hands and feet. The evolution is unpredictable and imposes regular radio-clinical surveillance because of the frequency of asymptomatic forms and of its seriousness, especially the neurological involvement could threaten functional and vital prognosis. Objectives To specify the contribution of imaging means in the diagnosis of rheumatoid cervical involvement and perform a comparison of these different imaging means to establish an exploration strategy. Methods This is a cross-sectional and descriptive retrospective study of 55 patients with RA which evolves since more than two years. All patients were explored by standard radiographs. CT and/or cervical MRI were performed according to the radiological findings. Results The mean age of the patients was 57.55 ± 13.59 years with a female predominance (72.7%). Functional signs were dominated by neck pain (87.3%). The stiffness of the cervical spine was the most recovered physical sign (69.1%). In imaging, cervical involvement was dominated by atloido-axoidal subluxations (AAS) in 50.9% and pannus of C1-C2 (14.54%). Among AAS, anterior AAS was the most common (40%) followed by vertical AAS (7.27%) then lateral and rotary (both in 1.81%). Subaxial subluxation was found in 14.54% of cases. Standard radiographs detected 38.2% of previous AAS versus 20% on MRI. CT allowed a better study of rotatory and lateral subluxations. MRI detected pannus of C1-C2 and assessed the neurological impact of the various cervical rheumatoid lesions. Conclusion Clinical examination alone remains insufficient in the evaluation of the rheumatoid cervical spine. Imaging has thus emerged as a key examination in exploration and therapeutic orientation. The standard radiography with its different incidences is the first-line examination. CT and MRI will be discussed as second-line. CT essentially detects atypical subluxations and bone lesions. MRI is the exam of choice for the study of pannus and neurological repercussions. References [1] Currier B, Coblyn J. Cervical subluxation in rheumatoid arthritis. Available at:https://www.uptodate.com/contents/cervical-subluxation-in-rheumatoid-arthritis. Accessed March 23, 2018 Disclosure of Interests None declared |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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