EURORAD ESR

Case 11507

Rheumatoid arthritis - with cervical spine manifestations

Author(s)
Weerakkody Y1

Royal Perth Hospital,
Western Australia;
Email:rachmaninov31@hotmail.com
1FRANZCR
 
Patient
female, 70 year(s)
 
 
  • Figure 1
    Lateral C spine radiographs
     

    Advanced multilevel uncovertebral and facet joint degenerative changes are shown. Anterior translation of C1 on C2 also shown with an anterior atlanto-odontoid distance of approximately 6mm. C3-5 predominant spinous...

     
    Area of Interest: Musculoskeletal spine; Imaging Technique: Conventional radiography; Procedure: Education; Special Focus: Pathology;

    On the flexion view, overall cervical movement is reduced although there is no evidence of any significant interval translation to suggest dynamic instability.

     
    Area of Interest: Musculoskeletal spine; Imaging Technique: Conventional radiography; Procedure: Education; Special Focus: Pathology;
     
     
  • Figure 2
    CT of cervical spine
     

    Sagittal CT image (midline) demonstrates marked erosion of the odontoid peg (arrowed) and atlanto-axial subluxation with anterior-translation of C1 of C2.

     
    Area of Interest: Musculoskeletal spine; Imaging Technique: CT; Procedure: Education; Special Focus: Pathology;

    Sagittal CT image shows superior migration of the odontoid peg (cranial settling) with the odontoid tip at 6mm above the McGregor line (drawn from hard palate to occiput).

     
    Area of Interest: Musculoskeletal spine; Imaging Technique: CT; Procedure: Education; Special Focus: Pathology;

    Sagittal CT image (slightly more laterally) demonstrates moderate apophyseal (facet) joint arthropathy dominating at the upper to mid cervical levels (arrowed). Multilevel uncovertebral degenerative changes are also...

     
    Area of Interest: Musculoskeletal spine; Imaging Technique: CT; Procedure: Education; Special Focus: Pathology;

    Sagittal CT image (obtained further laterally) shows fusion of the left C2/3 apophyseal (facet) joint (arrowed).

     
    Area of Interest: Musculoskeletal spine; Imaging Technique: CT; Procedure: Education; Special Focus: Pathology;

    Coronal CT image demonstrates left lateral subluxation of the dens, fusion of the left C2/3 apophyseal (facet) joint and advanced degenerative changes with sclerosis bilaterally affecting multiple cervical apophyseal...

     
    Area of Interest: Musculoskeletal spine; Imaging Technique: CT; Procedure: Education; Special Focus: Pathology;
     
     
Advanced multilevel uncovertebral and facet joint degenerative changes are shown. Anterior translation of C1 on C2 also shown with an anterior atlanto-odontoid distance of approximately 6mm. C3-5 predominant spinous process erosion is also present.
 
On the flexion view, overall cervical movement is reduced although there is no evidence of any significant interval translation to suggest dynamic instability.
 
Sagittal CT image (midline) demonstrates marked erosion of the odontoid peg (arrowed) and atlanto-axial subluxation with anterior-translation of C1 of C2.
 
Sagittal CT image shows superior migration of the odontoid peg (cranial settling) with the odontoid tip at 6mm above the McGregor line (drawn from hard palate to occiput).
 
Sagittal CT image (slightly more laterally) demonstrates moderate apophyseal (facet) joint arthropathy dominating at the upper to mid cervical levels (arrowed). Multilevel uncovertebral degenerative changes are also shown.
 
Sagittal CT image (obtained further laterally) shows fusion of the left C2/3 apophyseal (facet) joint (arrowed).
 
Coronal CT image demonstrates left lateral subluxation of the dens, fusion of the left C2/3 apophyseal (facet) joint and advanced degenerative changes with sclerosis bilaterally affecting multiple cervical apophyseal (facet) joints.
 
 
 
Home Search Sections Teaching Cases History FAQ Case Archives Contact Login Disclaimer Imprint Switch to MOBILE version
View desktop version