The Journal of Bone and Joint Surgery, Vol 68, Issue 2 189-198, Copyright © 1986 by Journal of Bone and Joint Surgery, Inc
Changes in the cervical spine in juvenile rheumatoid arthritis
RN Hensinger, PD DeVito and CG Ragsdale
One hundred and twenty-one patients with juvenile rheumatoid arthritis were
studied clinically and roentgenographically for evidence of disease of the
cervical spine. None of the fifty-seven patients with pauciarticular-onset
juvenile rheumatoid arthritis had cervical symptoms or signs, and only one
had minor roentgenographic changes of disease in the cervical spine. In
contrast, clinical stiffness and roentgenographic changes in the cervical
spine occurred commonly in the fifty-one patients with polyarticular-onset
disease and in the thirteen patients with systemic-onset disease. Despite
extensive roentgenographic involvement of the cervical spine, however, pain
in the neck was not a common complaint. Neither severe pain in the neck nor
torticollis, occurring either separately or concomitantly, is frequently
found in patients with juvenile rheumatoid arthritis, and its presence may
suggest an intercurrent problem such as a fracture or infection. As
patients with juvenile rheumatoid arthritis rarely have disease in the
cervical spine alone, the patient should be carefully examined for
involvement of multiple joints.