RT Journal Article
SR Electronic
T1 Classification of Odontoid Destruction in Patients with Rheumatoid Arthritis Using Reconstructed Computed Tomography: Reference to Vertical Migration
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 863
OP 867
DO 10.3899/jrheum.100942
VO 38
IS 5
A1 HIROFUMI SHIMADA
A1 MASAHIKO ABEMATSU
A1 YASUHIRO ISHIDO
A1 ICHIRO KAWAMURA
A1 HIROYUKI TOMINAGA
A1 MICHIHISA ZENMYO
A1 TAKUYA YAMAMOTO
A1 EIJI TAKETOMI
A1 SETSURO KOMIYA
A1 KOSEI IJIRI
YR 2011
UL http://www.jrheum.org/content/38/5/863.abstract
AB Objective.To reveal the factors that determine the natural course of subluxation of occipital-cervical lesions in rheumatoid arthritis (RA). The atlanto-axial region is one of the most common locations for lesions in RA. Some cases progress from reducible atlanto-axial subluxation (AAS) to irreducible vertical migration, while others continue to exhibit reducible AAS. No study has revealed the factors that determine the natural course of subluxation. We focus on the odontoid as a key structure of the progression of occipito-cervical lesions and investigated this region in patients with RA using reconstructive computed tomography (CT) images, and analyzed factors in association with CT findings. Methods.Fifty-eight patients with RA and 40 age-matched controls, all women, were studied. Associated factors, including C-reactive protein, erythrocyte sedimentation rate, steroid usage, and the severity of local osteoporosis, were analyzed as measurements in association with odontoid destruction. Results.The destruction of odontoid and atlanto-odontoid joint were common in patients with RA. The more destruction observed in the odontoid process, the greater is the degree of progression of vertical migration. Local osteoporosis is a significant factor in odontoid destruction, based on a cortico-cancellous index of 42% in cases of grade III odontoid destruction. Conclusion.The odontoid process is a key structure in the progression of occipito-cervical lesions in patients with RA.