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Patients with RA may develop vertebral artery occlusion with cervical spine involvement
Using dynamic duplex ultrasonography, investigators of this prospective study found 6% of patients with rheumatoid arthritis developed positional vertebral artery occlusion associated with cervical spine involvement.
Researchers included 132 outpatients with rheumatoid arthritis in the prospective imaging study. The patients had a median age of 64 years and most were women. Their mean duration of rheumatoid arthritis (RA) was 10 years. Examinations were performed to measure the posterior atlantodental interval (PADI), the anterior atlantodental interval (AADI) and the Ranawat value.
If vertebral artery (VA) occlusion was detected, then CT angiography was conducted in the neutral position and in the same position where the VA occlusion was found, according to researchers.
Dynamic duplex ultrasonography revealed eight patients had VA occlusion, which was detected during neck rotation to the contralateral side in seven patients and with neck extension in one patient, according to the researchers. In all cases of VA occlusion, patients exhibited an AADI greater than 5 mm.
“This was the first study to investigate how many patients with RA had positional VA occlusion. Patients with a wider AADI, a narrower PADI, and a lower value of the Ranawat method, which indicated instability of the cervical spine, developed positional VA occlusion,” researchers wrote in the study. – by Robert Linnehan.
Disclosure: The researchers reported no relevant financial disclosures.