Abstract
That there is cervical spine involvement in rheumatoid arthritis is well known. However, bone destruction of the cervical spine is sometimes revealed through X-ray examination without there being any obvious clinical manifestation.
The cervical spines of 23 rheumatoid arthritis patients were investigated though lateralview plain X-ray films which were taken for an average period of 8.5 years (range, 5 to 15.4 years) . The criterion of Ball and Schilling was applied to investigate them and the following results were obtained : 1) The X-ray findings of the cervical spine showed that there was deterioration in accordance with the stage and class classifications of Steinbrocker's criteria. 2) Change in the upper cervical spine involvement, erosion of the dens, ventral dislocation of the atlas and basilar impression were clearly revealed as the rheumatoid arthritis progressed. But there was little relationship between these changes and neural deficit. 3) Changes in the middle and lower part of the cervical spine due to rheumatoid arthritis went together with the degenerative change, that is, spondylosis. However, osteoporosis was identified in most cases of subaxial subluxation in the cervical spine of rheumatoid arthritis.
