eMedicine Specialties > Radiology > Musculoskeletal

Rheumatoid Arthritis, Spine: Follow-up

Author: Michele Calleja, MD, FRCR, MRCP, Consultant Radiologist, Skeletal Radiology, Horton Hospital and NHS Treatment Centre, UK
Coauthor(s): Geoff Hide, MBBS, MRCP, FRCR, Consultant Musculoskeletal Radiologist, Department of Radiology, Freeman Hospital; Honorary Clinical Lecturer, Faculty of Medical Sciences, University of Newcastle upon Tyne
Contributor Information and Disclosures

Updated: Mar 25, 2009

Intervention

New biologic agents are being used for the treatment of rheumatoid arthritis, such as rituximab, abatacept, and anakinra. In a meta-analysis of randomized, placebo-controlled trials, performed by Salliot et al, high doses of anakinra (100 mg per day or more) were found to potentially increase the risk of serious infections developing in patients with rheumatoid arthritis. No increased risk of serious infection, however, was found to occur with rituximab or abatacept. In a meta-analysis of 5 trials of 2876 patients (2065 patients given anakinra, 781 placebo), Mertens and Singh found anakinra to be a relatively safe and moderately effective therapy with no statistically significant total and serious infections when compared to placebo.23,24

In a meta-analysis of dietary-intervention studies (15 trials, 837 patients) by Hagen et al, the benefits of dietary regimens were found to be inconclusive, but the authors noted that because of high dropout rates and weight loss, potential adverse effects should be considered.25
 


More on Rheumatoid Arthritis, Spine

Overview: Rheumatoid Arthritis, Spine
Imaging: Rheumatoid Arthritis, Spine
Follow-up: Rheumatoid Arthritis, Spine
Multimedia: Rheumatoid Arthritis, Spine
References
Further Reading
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References

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  2. Resnick D, Kyriakos M, Greenway GD. Rheumatoid arthritis. In: Diagnosis of Bone and Joint Disorders. Vol 2. 4th ed. Philadelphia: WB Saunders;. 2002: 891-974.

  3. Garrod AB. Nature and treatment of gout and rheumatic gout. London: Walton and Maberly;. 1859.

  4. Oostveen JC, Roozeboom AR, van de Laar MA, Heeres J, den Boer JA, Lindeboom SF. Functional turbo spin echo magnetic resonance imaging versus tomography for evaluating cervical spine involvement in rheumatoid arthritis. Spine. Jun 1 1998;23(11):1237-44. [Medline].

  5. Drosos AA, Lanchbury JS, Panayi GS, Moutsopoulos HM. Rheumatoid arthritis in Greek and British patients. A comparative clinical, radiologic, and serologic study. Arthritis Rheum. Jul 1992;35(7):745-8. [Medline].

  6. Papadopoulos IA, Katsimbri P, Katsaraki A, et al. Clinical course and outcome of early rheumatoid arthritis. Rheumatol Int. Jul 2001;20(5):205-10. [Medline].

  7. Pellicci PM, Ranawat CS, Tsairis P, Bryan WJ. A prospective study of the progression of rheumatoid arthritis of the cervical spine. J Bone Joint Surg Am. Mar 1981;63(3):342-50. [Medline].

  8. Rudge SR, Drury PL, Lloyd-Jones JK. Long-term corticosteroids and cervical subluxation in non-rheumatoid patients. Rheumatol Rehabil. May 1981;20(2):102-5. [Medline].

  9. Neva MH, Kauppi MJ, Kautiainen H, et al. Combination drug therapy retards the development of rheumatoid atlantoaxial subluxations. Arthritis Rheum. Nov 2000;43(11):2397-401. [Medline].

  10. Kauppi MJ, Neva MH, Laiho K, Kautiainen H, Luukkainen R, Karjalainen A, et al. Rheumatoid Atlantoaxial Subluxation Can Be Prevented by Intensive Use of Traditional Disease Modifying Antirheumatic Drugs. J Rheumatol. Feb 2009;36(2):273-278. [Medline].

  11. Hamilton JD, Johnston RA, Madhok R, Capell HA. Factors predictive of subsequent deterioration in rheumatoid cervical myelopathy. Rheumatology (Oxford). Jul 2001;40(7):811-5. [Medline].

  12. Paus AC, Steen H, Røislien J, Mowinckel P, Teigland J. High mortality rate in rheumatoid arthritis with subluxation of the cervical spine: a cohort study of operated and nonoperated patients. Spine. Oct 1 2008;33(21):2278-83. [Medline].

  13. Boden SD, Dodge LD, Bohlman HH, Rechtine GR. Rheumatoid arthritis of the cervical spine. A long-term analysis with predictors of paralysis and recovery. J Bone Joint Surg Am. Sep 1993;75(9):1282-97. [Medline].

  14. McGregor M. The significance of certain measurments of the skull in the diagnosis of basilar impression. Br J Radiol. 1948;21:171-81.

  15. Kelleher MO, McEvoy L, Yang JP, Kamel MH, Bolger C. Lateral mass screw fixation of complex spine cases: a prospective clinical study. Br J Neurosurg. Oct 2008;22(5):663-8. [Medline].

  16. Cakir B, Käfer W, Reichel H, Schmidt R. [Surgery of the cervical spine in rheumatoid arthritis. Diagnostics and indication]. Orthopade. Nov 2008;37(11):1127-40; quiz 1141. [Medline].

  17. Narváez JA, Narváez J, Serrallonga M, De Lama E, de Albert M, Mast R, et al. Cervical spine involvement in rheumatoid arthritis: correlation between neurological manifestations and magnetic resonance imaging findings. Rheumatology (Oxford). Dec 2008;47(12):1814-9. [Medline].

  18. Dvorak J, Grob D, Baumgartner H, et al. Functional evaluation of the spinal cord by magnetic resonance imaging in patients with rheumatoid arthritis and instability of upper cervical spine. Spine. Oct 1989;14(10):1057-64. [Medline].

  19. Janssen H, Weissman BN, Aliabadi P, Zamani AA. MR imaging of arthritides of the cervical spine. Magn Reson Imaging Clin N Am. Aug 2000;8(3):491-512. [Medline].

  20. Roche CJ, Eyes BE, Whitehouse GH. The rheumatoid cervical spine: signs of instability on plain cervicalradiographs. Clin Radiol. Apr 2002;57(4):241-9. [Medline].

  21. Roca A, Bernreuter WK, Alarcón GS. Functional magnetic resonance imaging should be included in the evaluation the cervical spine in patients with rheumatoid arthritis. J Rheumatol. Sep 1993;20(9):1485-8. [Medline].

  22. Weissman BN, Aliabadi P, Weinfeld MS, et al. Prognostic features of atlantoaxial subluxation in rheumatoid arthritispatients. Radiology. Sep 1982;144(4):745-51. [Medline].

  23. [Best Evidence] Mertens M, Singh JA. Anakinra for rheumatoid arthritis. Cochrane Database Syst Rev. Jan 21 2009;CD005121. [Medline].

  24. [Best Evidence] Salliot C, Dougados M, Gossec L. Risk of serious infections during rituximab, abatacept and anakinra treatments for rheumatoid arthritis: meta-analyses of randomised placebo-controlled trials. Ann Rheum Dis. Jan 2009;68(1):25-32. [Medline].

  25. [Best Evidence] Hagen KB, Byfuglien MG, Falzon L, Olsen SU, Smedslund G. Dietary interventions for rheumatoid arthritis. Cochrane Database Syst Rev. Jan 21 2009;CD006400. [Medline].

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Further Reading

Related eMedicine topics

Rheumatoid Arthritis

Rheumatoid Arthritis, Hands

Juvenile Rheumatoid Arthritis

Clinical guidelines

Ophthalmologic examinations in children with juvenile rheumatoid arthritis. American Academy of Pediatrics.  2006 May 1.  3 pages.  NGC:004963

Ottawa Panel evidence-based clinical practice guidelines for therapeutic exercises in the management of rheumatoid arthritis in adults. Ottawa Panel - Independent Expert Panel.  2004 Oct.  39 pages.  NGC:004019

Ottawa Panel evidence-based clinical practice guidelines for electrotherapy and thermotherapy interventions in the management of rheumatoid arthritis in adults. Ottawa Panel - Independent Expert Panel.  2004 Nov.  28 pages.  NGC:004020

Rituximab for the treatment of rheumatoid arthritis. National Institute for Health and Clinical Excellence (NICE) - National Government Agency [Non-U.S.].  2007 Aug.  26 pages.  NGC:005902

Abatacept for the treatment of rheumatoid arthritis. National Institute for Health and Clinical Excellence (NICE) - National Government Agency [Non-U.S.].  2008 Apr.  29 pages.  NGC:006483

Clinical trials

RESTART C0168Z05 Rheumatoid Arthritis Study

Evaluation of EULAR-RAID Score in Rheumatoid Arthritis Patients

Clinically Important Changes in Rheumatoid Arthritis

Ultrasonography as a Biomarker in Early Rheumatoid Arthritis

Health Outcomes in Rheumatoid Arthritis

Long-Term Evaluation of African Americans With Early Rheumatoid Arthritis (The CLEAR Study)

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Keywords

spinal arthritis, spinal rheumatoid arthritis, spinal RA, early RA, early rheumatoid arthritis, erosion formation, pseudocyst formation, advanced RA, advanced rheumatoid arthritis, rheumatoid factor, RhF, course I rheumatoid arthritis, monocyclic rheumatoid arthritis, course II rheumatoid arthritis, polycyclic rheumatoid arthritis, course III rheumatoid arthritis, progressive rheumatoid arthritis, rheumatoid spondylitis, rheumatoid arthritis

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Contributor Information and Disclosures

Author

Michele Calleja, MD, FRCR, MRCP, Consultant Radiologist, Skeletal Radiology, Horton Hospital and NHS Treatment Centre, UK
Michele Calleja, MD, FRCR, MRCP is a member of the following medical societies: Royal College of Radiologists
Disclosure: Nothing to disclose.

Coauthor(s)

Geoff Hide, MBBS, MRCP, FRCR, Consultant Musculoskeletal Radiologist, Department of Radiology, Freeman Hospital; Honorary Clinical Lecturer, Faculty of Medical Sciences, University of Newcastle upon Tyne
Geoff Hide, MBBS, MRCP, FRCR is a member of the following medical societies: British Medical Association, Royal College of Physicians, and Royal College of Radiologists
Disclosure: Nothing to disclose.

Medical Editor

Amilcare Gentili, MD, Clinical Professor of Radiology, University of California at San Diego; Consulting Staff, Department of Radiology, Thornton Hospital
Amilcare Gentili, MD is a member of the following medical societies: American Roentgen Ray Society, Radiological Society of North America, and Society of Skeletal Radiology
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

Lynne S Steinbach, MD, Chief of Musculoskeletal Radiology, Professor, Department of Radiology, University of California at San Francisco
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, Resolution Imaging Medical Corporation
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Felix S Chew, MD, MBA, EdM, Professor, Department of Radiology, Vice Chairman for Radiology Informatics, Section Head of Musculoskeletal Radiology, University of Washington
Felix S Chew, MD, MBA, EdM is a member of the following medical societies: American Roentgen Ray Society, Association of University Radiologists, and Radiological Society of North America
Disclosure: Nothing to disclose.

 
 
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