cervical spine involvement in rheumatoid arthritis (RA)

Introduction

50% of patients with seropositive RA have involvement of the cervical spine. The likelihood of cervical involvement parallels the severity of peripheral arthritis.

Clinical manifestations

• generally asymptomatic
• pain in the shoulders, occiput, neck or interscapular area
• less common presentations
  • lightheadedness or syncope
  • paresthesias of face or limbs
  • nystagmus
  • ataxia (may be sudden)
  • weakness of extremities or quadriplegia

Management

• surgery
• neurological or vascular compromise
• intractable local symptoms

Additional terms

• rheumatoid arthritis (RA)