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Rheumatoid arthritis of the cervical spine

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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The cervical spine is affected in 30% of the patients with RA. Typically, there is initial patchy degeneration which accentuates the stresses on the remaining mobile joints.

Classically, ligamentous erosion leads to joint laxity and subluxation at the following sites:

  • atlanto-axial joint
  • atlanto-occipital joint: leads to severe occipital headaches
  • mid-cervical region

The patient is typically female with neck pain and stiffness. Eventually, nerve compression may supervene: upper limb lower motor neurone signs and lower limb upper motor neurone signs.

Treatment is with a collar to relieve pain, and with spinal fusion if neurological signs are worsening.

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