Pathogenesis Of Cervical Discovertebral Destruction In Rheumatoid Arthritis

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Pyogenic Cervical Osteomyelitis Presenting as a Massive

elitis and rheumatoid arthritis of the cervical spine [2,3]. Low-grade or normal temperatures are common in both [I]. In this patient, the severe cervical spine pain was attributed to rheumatoid disease, notwithstanding the his- tory of staphylococcal sepsis. Although the damaged joints of rheumatoid arthritis

A RADIOLOGICALLY DISTINCTIVE OF LOW BACK PAIN

involves more than a single disc level. Discovertebral destruction in rheumatoid arthritis is well known in the cervical spine. Similar lesions sometimes occur in the dorsal and lumbar segments. The latter may be due in some cases to chronic endogenous trauma, associated with vertebral instability, rather than to rheumatoid

in rheumatoid

Rheumatoid involvement of the lumbar spine. Annals of the Rheumatic Diseases, 36, 524-531. Serumcopperlevels in rheumatoid arthritis Sir, Recent correspondence concerning the level and dis-tribution ofcopper in the serum ofpatients undergoing therapy for rheumatoid arthritis (Bajpayee, 1975; Sorensen, 1976a)andobservations that coppercomplexes

Correspondence

Recently, Martel (1977) has suggested that cervical discovertebral destruction in rheumatoid arthritis is a consequence ofcervical instability caused by apophyseal arthritis and ligament laxity. Supporting evidence for this concept are the appearance of apophyseal joint destruction at the same level as the involved disco-

r n a f S o u pi J ne Yoon and Keshavarzi et al J Spine 21 :2

4. Resnick D (1978) Thoracolumbar spine abnormalities in rheumatoid arthritis. Ann Rheum Dis 37: 389-391. 5. Martel W (1977) Pathogenesis of cervical discovertebral destruction in rheumatoid arthritis. Arthritis Rheum 20: 1217-1225. 6. Firestein GS (2005) Immunologic mechanisms in the pathogenesis of rheumatoid arthritis. J Clin Rheumatol 11

Medical and Surgical Management of Spinal Infections

* The least common of the rheumatoid cervical deformities * Develops late in the course of the disease. * Occurs secondary to destruction of the facet joints, interspinous ligament, and discovertebral junction. * Multiple levels are affected: classic stepladder deformity on lateral radiographs.

Lumbar Spondylolisthesis and Spondyloarthropathies

Rheumatoid Arthritis chronic systemic inflammatory disease that causes pain, heat, swelling and destruction of synovial joints characteristically involves hands, feet, wrists, elbows, hips, knees, ankles and cervical spine diagnosis based on clinical presentation and presence of rheumatoid factor in serum pathogenesis is unknown

Cervical discovertebral destruction, subaxial subluxation

18. Martel W: The occipital-atlantoaxial joints in rheumatoid arthritis and ankylosing spondylitis. Am J Roentgen01 19. Sharp J, Purser DW, Lawrence J: Rheumatoid arthritis of the cervical spine in the adult. Ann Rheum Dis 17:303- 313, 1958 20. Martel W: Pathogenesis of cervical discovertebral destruc- tion in rheumatoid arthritis.

Pathogenesis of Cervical Discovertebral Destruction in

rheumatoid arthritis. It is not surprising that lesions which are histologically characteristic for this disease occur in the diarthrodial joints throughout the spine (I) inasmuch as these joints are synovial. However severe osteochondral destruction is often found in the cervical discovertebral joints (2-6), and the pathogenesis of these

Neck Pain from a Rheumatologic Perspective

pathogenesis of RA is not well understood but it is believed that an autoimmune inflammatory response against the synovium is triggered by an unknown risk factor in a genetically susceptible individual. RA is the most common inflammatory arthritis affecting the cervical spine,1 affecting 17% to 84%2,3 of patients with RA. However,