Document Detail

The cervical spine in juvenile chronic arthritis.
MedLine Citation:
PMID:  14588266     Owner:  NLM     Status:  MEDLINE    
BACKGROUND CONTEXT: In patients with juvenile chronic arthritis (JCA) the cervical spine is often affected, leading to pain and functional limitations. PURPOSE: To describe the frequency of the radiographic abnormalities in the cervical spine of a large series of patients with JCA, examined after skeletal maturity. STUDY DESIGN: Consecutive patients with JCA, who had cervical spine radiographs available taken at adult age (>18 years) were included in the study from one outpatient clinic and one rheumatology ward in the Rheumatism Foundation Hospital, Heinola, Finland. PATIENT SAMPLE: The series consisted of 159 patients fulfilling the diagnostic criteria of the European League Against Rheumatism for JCA. OUTCOME MEASURES: Evaluation of cervical spine radiographs for inflammatory changes. METHODS: Inflammatory changes in the cervical spine radiographs were measured as well as the size of the fourth cervical vertebra. Patient records were studied. The statistical analysis was calculated by Student's t-test or Mann-Whitney U test. RESULTS: In 98 cases (62%) some inflammatory changes were detected in the cervical spine. Apophyseal joint ankylosis was noted in 65 patients (41%), anterior atlantoaxial subluxation in 27 (17 %) and atlantoaxial impaction in 39 (25 %). The fourth cervical vertebra was abnormally small in 41 patients (26%). CONCLUSIONS: Radiographically, the most frequent inflammatory change in the cervical spine of patients with JCA was apophyseal joint ankylosis at multiple levels. Atlantoaxial impaction and anterior atlantoaxial subluxation were typical of the upper cervical spine. Clinically, these changes tend to limit neck movements. A small C4 vertebral body was seen in patients with early disease onset and short body stature.
Kari Laiho; Anneli Savolainen; Hannu Kautiainen; Pertti Kekki; Markku Kauppi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The spine journal : official journal of the North American Spine Society     Volume:  2     ISSN:  1529-9430     ISO Abbreviation:  Spine J     Publication Date:    2002 Mar-Apr
Date Detail:
Created Date:  2003-10-31     Completed Date:  2003-12-03     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  101130732     Medline TA:  Spine J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  89-94     Citation Subset:  IM    
Rheumatism Foundation Hospital, FIN-18120 Heinola, Finland.
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MeSH Terms
Age of Onset
Ankylosis / epidemiology*,  radiography*
Arthritis, Juvenile Rheumatoid / epidemiology*,  radiography*,  surgery
Atlanto-Axial Joint / pathology,  radiography
Cervical Vertebrae / pathology,  radiography*
Middle Aged
Spondylitis / epidemiology*,  radiography*

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