Atlanto-axial luxation Basilar invagination Subaxial instability a b s t r a c t Introduction: The involvement of the cervical spine is a common feature of rheumatoid arthritis (RA). Objective: To study the prevalence of radiographic changes of the cervical spine in patients with RA and their association with clinical and serological profi les of the disease. Methods: We analysed lateral (neutral position, hyperextension, hyperfl exion) and transoral views of cervical spine radiographs from 80

more »

... ndividuals with RA to investigate the presence of atlanto-axial subluxation (AAS), basilar invagination (BI), and subaxial instability (SAI). Demographic, clinical (nodules, interstitial pneumonitis, secondary Sjögren's syndrome, medications etc.), and serologic (rheumatoid factor -RF, cyclic citrullinated peptide antibody -anti-CCP, and antinuclear factor -ANF) data were obtained from the clinical records. Results: Cervical spine misalignments were identifi ed in 26/80 (32.5%) participants; AAS occurred in 12/80 (15%) participants, BI in 6/80 (7.5%), and SAI in 13/80 (32.5%). Odontoid erosions were identifi ed in 16/80 (20.0%) participants. Cervical spine misalignment exhibited associations with age at onset and disease duration (P = 0.03 and 0.02, respectively). No associations were identifi ed between the cervical spine changes and the participants' ethnicity or gender, presence of nodules, interstitial pneumonitis, secondary Sjögren's syndrome, RF, ANF, or anti-CCP. The participants with cervical spine misalignment exhibited higher frequencies of odontoid erosion (P = 0.03). Conclusions: Cervical spine misalignment was a common radiographic fi nding and occurred more frequently in participants with earlier onset and longer length of RA. monite intersticial, Sjögren secundário, FR, FAN ou anti-CCP. Pacientes com alterações do eixo cervical apresentavam mais erosões de odontoide (P = 0,03). Conclusões: Alterações radiológicas em eixo de coluna cervical são comuns e aparecem mais frequentemente em indivíduos com diagnóstico mais precoce de AR e maior tempo de doença.