Rheumatoid arthritis of the cervical spine

Case contributed by Muhammad Essam
Diagnosis almost certain

Presentation

Known case of rheumatoid arthritis, complaining of bilateral upper and lower limb weakness

Patient Data

Age: 75 years
Gender: Female

Arthropathic changes are seen implicating the atlanto-axial articulation with odontoid process erosive changes and evident pannus formation, which is seen indenting and kinking the upper cervical cord against the posterior arch of atlas, resulting in an intramedullary area of compressive cord myelopathy.

Cervical spondylosis with multi-level disc lesions and degenerative foraminal compromise are also noted.

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