ArticleNeuroradiology2010
MRI of the transverse and alar ligaments in rheumatoid arthritis: feasibility and relations to atlantoaxial subluxation and disease activity.
Article in Neuroradiology, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 11 citations in OpenAlex.
- Magnetic resonance imaging characteristics of atlanto-axial subluxation in 42 dogs: Analysis of joint cavity size, subluxation distance, and craniocervical junction anomalies.Open veterinary journal · 2023Article
- Thinking beyond pannus: a review of retro-odontoid pseudotumor due to rheumatoid and non-rheumatoid etiologies.Skeletal radiology · 2019Review
- Are two readers more reliable than one? A study of upper neck ligament scoring on magnetic resonance images.BMC medical imaging · 2013Article
- Magnetic resonance imaging anatomy of the craniovertebral ligaments: A radiological study with confirmatory dissection.Journal of craniovertebral junction & spineArticle
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionDysfunctional transverse and alar craniovertebral ligaments can cause instability and osseous destruction in rheumatoid arthritis (RA). This study examined (1) the feasibility of high-resolution magnetic resonance imaging (MRI) of these ligaments in RA and (2) the relation between ligament high-signal changes and atlantoaxial subluxation and RA duration/severity.
methodsConsecutive RA patients (n=46) underwent clinical examination, functional radiography, and high-resolution MRI. Two blinded radiologists rated MRI image quality, graded ligament high-signal changes 0-3 on proton-weighted sequences using an existing grading system, and assessed cervical spine rheumatic changes on short tau inversion recovery images. Agreement was analyzed using kappa and relations using multiple logistic regression.
resultsMRI images had good quality in 42 (91.3%) of 46 patients and were interpretable in 44 (32 women and 12 men, median age/disease duration 60.4/9.1 years). MRI grades 2-3 changes of the transverse and alar ligaments showed moderate and good interobserver agreement (kappa 0.59 and 0.78), respectively, and prevalence 31.8% and 34.1%. Such ligament changes were more frequent with increasing anterior atlantoaxial subluxation (p=0.012 transverse, p=0.028 alar), higher erythrocyte sedimentation rate (p=0.003 transverse), positive rheumatoid factor (p=0.002 alar), and neck pain (p=0.004 alar).
conclusionThis first study of high-resolution MRI of these ligaments in RA showed high feasibility and relations with atlantoaxial subluxation, RA disease activity, and neck pain. The clinical usefulness of such MRI needs further evaluation.
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