Summary
The authors report a case of spine involvement in a severe case of rheumatoid arthritis treated with corticosteroids. First, the patient developed acute back pain, related to costovertebral joints arthritis at levels T9–T10. Then, neck pain and cord involvement yielded to diagnosis of cervical interapophyseal joints arthritis; there was a C5–C6 subluxation which necessitated surgical treatment. The conjunction of these two rheumatoid localizations is an uncommon feature. Study by the CT scan is valuable when rheumatoid arthritis of the spine is suspected. Lower cervical spine subluxation, even severe, may be well tolerated. Surgery is necessary when there is medullary involvement.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Garrod AE (1890) A treatise on rheumatism and rheumatoid arthritis. Griffin, London
Ranawat CS, O'Leary P, Pellicci P, Tsairis P, Marchisello P, Dorr L (1979) Cervical spine fusion in rheumatoid arthritis. J Bone Joint Surg [A] 61:1003–1010
Winfield J, Cooke D, Brook AS, Corbett M (1981) A prospective study of the radiological changes in the cervical spine in early rheumatoid disease. Ann Rheum Dis 40:109–114
Meijers KAE, Beusekom GT Van, Luyendijk W, Duijfjes F (1974) Dislocation of the cervical spine with cor compression in rheumatoid arthritis. J Bone Joint Surg [B] 56:668–680
Hopkins JS (1967) Lower cervical rheumatoid subluxation with tetraplegia. J Bone Joint Surg [B] 49:46–51
Resnick D (1978) Thoracolumbar spine abnormalities in rheumatoid arthritis. Ann Rheum Dis 37:389–391
Bywaters EGL (1981) Thoracic intervertebral discitis in rheumatoid arthritis due to costo-vertebral joint involvement. Rheumatol Int 1:83–97
Crockard HA, Essigman WK, Stevens JM, Pozo JL, Ransford AO, Kendall BE (1985) Surgical treatment of cervical cord compression in rheumatoid arthritis. Ann Rheum Dis 44:809–816
Cohen MJ, Ezekiel J, Persellin RH (1978) Costo-vertebral and costotransverse joint involvement in rheumatoid arthritis. Ann Rheum Dis 37:473–475
Benhamou CL, Roux C, Benhamou-Mayoux A, Gauvain JB, Corlieu P, Viala JF, Amor B (1987) Arthrites costovertébrales inférieures de la pelvispondylite rhumatismale. Révélation pseudo-urologique. Rev Rhum 54:203–207
Fedele FA, Ho G, Dorman BA (1986) Pseudoaneurysm of the vertebral artery: a complication of rheumatoid cervical spine disease. Arthritis Rheum 29:136–141
Pellicci PM, Ranawat CS, Tsairis P, Bryan WJ (1981) A prospective study of the progression of rheumatoid arthritis of the cervical spine. J Bone Joint Surg [A] 63:342–350
Martel W (1977) Pathogenesis of cervical discovertebral destruction in rheumatoid arthritis. Arthritis Rheum 20:1217–1225
King TT (1985) Editorial: Rheumatoid subluxations of the cervical spine. Ann Rheum Dis 44:807–808
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Benhamou, CL., Roux, C., Viala, JF. et al. Thoracic and lower cervical spine involvement in a case of rheumatoid arthritis. Rheumatol Int 9, 39–41 (1989). https://doi.org/10.1007/BF00270288
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00270288