Subaxial subluxation (SAS): involvement of cervical spine below C1-C2 level
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
Baek IW et al: Risk factors for cervical spine instability in patients with rheumatoid arthritis. Clin Rheumatol. 40(2):547-55, 2021
Guyard T et al: Reproducibility and diagnostic value of a new method using ratios to diagnose anterior atlanto-axial subluxation on plain radiographs. Joint Bone Spine. 88(5):105229, 2021
Uchino Y et al: Risk factors associated with cervical spine lesions in patients with rheumatoid arthritis: an observational study. BMC Musculoskelet Disord. 22(1):408, 2021
Joo P et al: Surgical management of the lumbar spine in rheumatoid arthritis. Global Spine J. 10(6):767-74, 2020
Shlobin NA et al: Cervical spine manifestations of rheumatoid arthritis: a review. Neurosurg Rev. 44(4):1957-65, 2020
Suzuki A et al: Do rheumatoid arthritis patients have low back pain or radiological lumbar lesions more frequently than the healthy population? - Cross-sectional analysis in a cohort study with age and sex-matched healthy volunteers. Spine J. 20(12):1995-2002, 2020
Reijnierse M et al: Magnetic resonance imaging of rheumatoid arthritis: peripheral joints and spine. Semin Musculoskelet Radiol. 22(2):127-46, 2018
Mańczak M et al: Cervical spine instability in the course of rheumatoid arthritis - imaging methods. Reumatologia. 55(4):201-7, 2017
Gillick JL et al: Rheumatoid arthritis and the cervical spine: a review on the role of surgery. Int J Rheumatol. 2015:252456, 2015
Joaquim AF et al: Radiological evaluation of cervical spine involvement in rheumatoid arthritis. Neurosurg Focus. 38(4):E4, 2015
Wallis D et al: Tumour necrosis factor inhibitor therapy and infection risk in axial spondyloarthritis: results from a longitudinal observational cohort. Rheumatology (Oxford). 54(1):152-6, 2015
Del Grande M et al: Cervical spine involvement early in the course of rheumatoid arthritis. Semin Arthritis Rheum. 43(6):738-44, 2014
Iizuka H et al: Effect of a reduction of the atlanto-axial angle on the cranio-cervical and subaxial angles following atlanto-axial arthrodesis in rheumatoid arthritis. Eur Spine J. 22(5):1137-41, 2013
Kaito T et al: Predictors for the progression of cervical lesion in rheumatoid arthritis under the treatment of biological agents. Spine (Phila Pa 1976). 38(26):2258-63, 2013
Kauppi MJ et al: Rheumatoid atlantoaxial subluxation can be prevented by intensive use of traditional disease modifying antirheumatic drugs. J Rheumatol. 36(2):273-8, 2009
Narváez JA et al: Bone marrow edema in the cervical spine of symptomatic rheumatoid arthritis patients. Semin Arthritis Rheum. 38(4):281-8, 2009
Restrepo CS et al: Imaging appearances of the sternum and sternoclavicular joints. Radiographics. 29(3):839-59, 2009
Goel A et al: Immediate postoperative regression of retroodontoid pannus after lateral mass reconstruction in a patient with rheumatoid disease of the craniovertebral junction. Case report. J Neurosurg Spine. 9(3):273-6, 2008
Iizuka H et al: Relationship between the morphology of the atlanto-occipital joint and the radiographic results in patients with atlanto-axial subluxation due to rheumatoid arthritis. Eur Spine J. 17(6):826-30, 2008
Kelleher MO et al: Lateral mass screw fixation of complex spine cases: a prospective clinical study. Br J Neurosurg. 22(5):663-8, 2008
Narváez JA et al: Cervical spine involvement in rheumatoid arthritis: correlation between neurological manifestations and magnetic resonance imaging findings. Rheumatology (Oxford). 47(12):1814-9, 2008
Neo M: Treatment of upper cervical spine involvement in rheumatoid arthritis patients. Mod Rheumatol. 18(4):327-35, 2008
Paus AC et al: High mortality rate in rheumatoid arthritis with subluxation of the cervical spine: a cohort study of operated and nonoperated patients. Spine. 33(21):2278-83, 2008
Takatori R et al: In vivo segmental motion of the cervical spine in rheumatoid arthritis patients with atlantoaxial subluxation. Clin Exp Rheumatol. 26(3):442-8, 2008
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Abbreviations
Rheumatoid arthritis (RA)
Definitions
Chronic progressive systemic inflammatory disease in which joints are primary target
Subaxial subluxation (SAS): involvement of cervical spine below C1-C2 level
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
Baek IW et al: Risk factors for cervical spine instability in patients with rheumatoid arthritis. Clin Rheumatol. 40(2):547-55, 2021
Guyard T et al: Reproducibility and diagnostic value of a new method using ratios to diagnose anterior atlanto-axial subluxation on plain radiographs. Joint Bone Spine. 88(5):105229, 2021
Uchino Y et al: Risk factors associated with cervical spine lesions in patients with rheumatoid arthritis: an observational study. BMC Musculoskelet Disord. 22(1):408, 2021
Joo P et al: Surgical management of the lumbar spine in rheumatoid arthritis. Global Spine J. 10(6):767-74, 2020
Shlobin NA et al: Cervical spine manifestations of rheumatoid arthritis: a review. Neurosurg Rev. 44(4):1957-65, 2020
Suzuki A et al: Do rheumatoid arthritis patients have low back pain or radiological lumbar lesions more frequently than the healthy population? - Cross-sectional analysis in a cohort study with age and sex-matched healthy volunteers. Spine J. 20(12):1995-2002, 2020
Reijnierse M et al: Magnetic resonance imaging of rheumatoid arthritis: peripheral joints and spine. Semin Musculoskelet Radiol. 22(2):127-46, 2018
Mańczak M et al: Cervical spine instability in the course of rheumatoid arthritis - imaging methods. Reumatologia. 55(4):201-7, 2017
Gillick JL et al: Rheumatoid arthritis and the cervical spine: a review on the role of surgery. Int J Rheumatol. 2015:252456, 2015
Joaquim AF et al: Radiological evaluation of cervical spine involvement in rheumatoid arthritis. Neurosurg Focus. 38(4):E4, 2015
Wallis D et al: Tumour necrosis factor inhibitor therapy and infection risk in axial spondyloarthritis: results from a longitudinal observational cohort. Rheumatology (Oxford). 54(1):152-6, 2015
Del Grande M et al: Cervical spine involvement early in the course of rheumatoid arthritis. Semin Arthritis Rheum. 43(6):738-44, 2014
Iizuka H et al: Effect of a reduction of the atlanto-axial angle on the cranio-cervical and subaxial angles following atlanto-axial arthrodesis in rheumatoid arthritis. Eur Spine J. 22(5):1137-41, 2013
Kaito T et al: Predictors for the progression of cervical lesion in rheumatoid arthritis under the treatment of biological agents. Spine (Phila Pa 1976). 38(26):2258-63, 2013
Kauppi MJ et al: Rheumatoid atlantoaxial subluxation can be prevented by intensive use of traditional disease modifying antirheumatic drugs. J Rheumatol. 36(2):273-8, 2009
Narváez JA et al: Bone marrow edema in the cervical spine of symptomatic rheumatoid arthritis patients. Semin Arthritis Rheum. 38(4):281-8, 2009
Restrepo CS et al: Imaging appearances of the sternum and sternoclavicular joints. Radiographics. 29(3):839-59, 2009
Goel A et al: Immediate postoperative regression of retroodontoid pannus after lateral mass reconstruction in a patient with rheumatoid disease of the craniovertebral junction. Case report. J Neurosurg Spine. 9(3):273-6, 2008
Iizuka H et al: Relationship between the morphology of the atlanto-occipital joint and the radiographic results in patients with atlanto-axial subluxation due to rheumatoid arthritis. Eur Spine J. 17(6):826-30, 2008
Kelleher MO et al: Lateral mass screw fixation of complex spine cases: a prospective clinical study. Br J Neurosurg. 22(5):663-8, 2008
Narváez JA et al: Cervical spine involvement in rheumatoid arthritis: correlation between neurological manifestations and magnetic resonance imaging findings. Rheumatology (Oxford). 47(12):1814-9, 2008
Neo M: Treatment of upper cervical spine involvement in rheumatoid arthritis patients. Mod Rheumatol. 18(4):327-35, 2008
Paus AC et al: High mortality rate in rheumatoid arthritis with subluxation of the cervical spine: a cohort study of operated and nonoperated patients. Spine. 33(21):2278-83, 2008
Takatori R et al: In vivo segmental motion of the cervical spine in rheumatoid arthritis patients with atlantoaxial subluxation. Clin Exp Rheumatol. 26(3):442-8, 2008
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