Rheumatoid arthritis and ankylosing spondylitis with cervical involvement and characteristics

Abstract

Rheumatoid Arthritis and Ankylosing Spondylitis are systemic, inflammatory and chronic diseases. Cervical vertebra involvement is common and may cause disability in patients. The aim of this study; to determine the clinical and radiological features of cervical vertebrae involvement in patients with Rheumatoid Arthritis and Ankylosing Spondylitis and to assess the disability and quality of life of patients with different measurement methods. Forty-two patients with Ankylosing Spondylitis (AS) were diagnosed according to Modified New York criteria and 54 Rheumatoid Arthritis (RA) patients meeting the American College of Rheumatology (ACR) criteria were included. Cervical vertebra joint range of motion and neurological examination of all patients were evaluated. Open odontoid radiographs, lateral cervical graphs in the flexion and extension positions and MRI images were taken. Values such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and Rheumatoid factor (RF) were determined in all patients. Disease activity was assessed in patients with RA using DAS 28 and BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) in AS patients. In the evaluation of quality of life and disability for RA patients, the health assessment questionnaire (HAQ), the Rheumatoid Arthritis Quality of Life Scale (RAQOL), Short Form 36 (SF36), AS patients were interviewed for the Quality of Life Scale-SPA (SPA-QOL), Ankylosing Spondylitis Life Quality Scale (ASQOL), Short Form 36. 48 of the RA patients were female and 8 were female. The average age was 50.7 years Six patients with RA and AS had AAS identified by radiography. Pannus was detected on MRI of 5 patients with RA and 7 patients with AS. 80% of our patients with RA and 71% of our patients with AS who detected pannus formation by MRI were AA joint range was below 3 mm. There was no significant relationship between disease activity criteria and AAS. There was a significant relationship between AAS and age in RA patients (p < 0.05). Patients with RA had a worse quality of life. Cervical vertebral involvement can lead to deterioration of the quality of life of patients. For this reason, cervical spine involvement should be specifically investigated following the disease. Plain radiographs can provide reliable and practical measurements in determining cervical involvement MRI can be consulted if needed. Assessment of atlantoaxial joint integrity in patients with minimal cervical symptoms. Early diagnosis and treatment of cervical spine disorders is important.