AB0197 RHEUMATOID ARTHRITIS DISEASE ACTIVITY AND CERVICAL SPINE INVOLVEMENT

Abstract

BackgroundThe prevalence of cervical spine involvement in rheumatoid arthritis (RA) varies between 17 and 86%. Cervical spine involvement is in third place after hand-wrist and foot involvement. The activity of RA is manifested by inflammation of all joints.ObjectivesTo study the characteristics of patients with rheumatoid arthritis and research a relationship between cervical spine involvement and disease activity in rheumatoid arthritis.MethodsWe conducted a multicenter, prospective, descriptive, cross-sectional study in 300patients with RA between 2013-2018. We collected demographic data, Body mass index (BMI), disease duration, Disease Activity Score of 28 joints (DAS28), (Health Assessment Questionnaire (HAQ), CRP, ESR, the rheumatoid factor (RF), ACPA. A radiological assessment of the cervical spine was requested for all patients, including a radiograph of the cervical spine from the front with the mouth open, a neutral profile, and dynamic flexion and hyperextension views. The activity of RA was assessed by DAS28. We study the relationship between cervical spine involvement (CSI) and disease activity in RA.Results80, 3% were female), sex ratio H/F) was 0,24, the mean age was 51, 17±12,68 years, the BMI was 26,11±5,25, 67, 66 % had comorbidities, the most frequent were osteoporosis (30%), obesity (24%), hypertension (21,7%). RA mean duration was 13±9 years, mean DAS 28 was 4,68±1,5 mean HAQ was 1,01±0,69, mean CRP was 15,50 ±12 mg/L, mean ESR was 41,89 ±26,8mm, rheumatoid factor was positive in 70,6% and ACPA were positives in 77,3%. The standard radiographs of cervical spine found 53 (17, 66%) patients with CSI The various lesions of the cervical spine were atlantoaxial subluxations 13%, 3,66% of lateral atloїdo-axoїd subluxations, vertical subluxations in 0,66%, C1C2 arthropathies in 2,33% spondylolisthesis in 2%, and 0,33% of spondylodiscitis. The results of the univariate and multivariate analysis did not find a relationship between CSI and DAS28A (p=0, 66).ConclusionCervical spine involvement in rheumatoid arthritis was common in our study. We did not find a relationship between cervical spine involvement and disease activity in rheumatoid arthritis.