cervical spine involvement in rheumatoid arthritis (RA)

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: 1) generally asymptomatic 2) pain in the shoulders, occiput, neck or interscapular area 3) less common presentations a) lightheadedness or syncope b) paresthesias of face or limbs c) nystagmus d) ataxia (may be sudden) e) weakness of extremities or quadriplegia Management: - surgery 1) neurological or vascular compromise 2) intractable local symptoms

References

Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 823