{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T18:10:00Z","timestamp":1772993400884,"version":"3.50.1"},"reference-count":52,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T00:00:00Z","timestamp":1750291200000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Musculoskeletal Care"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cervical spine involvement remains one of the more serious complications of rheumatoid arthritis (RA). Several factors interfere with the occurrence of this complication. The aim of this work was to identify the risk factors associated with cervical involvement, specifying the contribution of MRI in screening for rheumatoid cervical spine and discussing the value of standard X\u2010rays.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross\u2010sectional study included 100 patients with RA who underwent both standard radiography and MRI of the cervical spine. Clinical, paraclinical and therapeutic data were collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Cervical pain was the predominant functional sign. It was mechanical in 44% of cases and inflammatory in 29%. Physical signs revealed on clinical examination included: pain on cervical spine mobilisation (49%), cervical stiffness (37%) and abnormal neurological examination in 3% of cases. Standard radiographs revealed C1\u2013C2 instability in 52% of cases: vertical displacement (28%), rotatory displacement (22%), anterior displacement (19%) and lateral displacement (1%). MRI confirmed the presence of the following types of atlantoaxial subluxation: vertical (34%) and anterior subluxation (27%). Other lesions were identified on MRI: synovial thickening (31%) with contrast enhancement (17%), hyperintensity on diffusion\u2010weighted imaging (DWI; 6%) and odontoid erosion (16%). Cervico\u2010Medullar Angle (CMA) was pathological (CMA\u00a0&lt;\u00a0135\u00b0) in 3% of patients. A study of the correlation between patient\u2010related parameters, RA\u2010related parameters, cervical symptomatology\u2010related parameters and rheumatoid C1\u2013C2 involvement concluded that age was positively correlated with C1\u2013C2 instability (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.036), as was the presence of Rheumatoid Factor (RF) (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.038), coxitis (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.042) and dry eye syndrome (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.039). Cervical spine stiffness was positively correlated with C1\u2013C2 instability (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.01). The presence of inflammatory cervical pain (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00), and painful mobilisation on examination (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.03) were correlated with C1\u2013C2 synovitis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The \u2018RA and cervical spine\u2019 entity is associated with phenotypes of seropositive, destructive RA, with peripheral synovitis and systemic manifestations. Systematic clinical and radiological screening for this condition is essential to preserve functional prognosis. Diffusion imaging of the craniocervical region appears to be a valuable adjunct for the quantitative assessment of synovitis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/msc.70145","type":"journal-article","created":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T21:49:42Z","timestamp":1750369782000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk Factors of Cervical Spine Involvement in Patients With Rheumatoid Arthritis in the Imaging Era: A Cross\u2010Sectional Study"],"prefix":"10.1002","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5955-9845","authenticated-orcid":false,"given":"Ichrak","family":"Mnif","sequence":"first","affiliation":[{"name":"Departement of Rheumatology Hedi Chaker Hospital  Sfax Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Afef","family":"Feki","sequence":"additional","affiliation":[{"name":"Departement of Rheumatology Hedi Chaker Hospital  Sfax Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Imen","family":"Sellami","sequence":"additional","affiliation":[{"name":"Departement of Occupational Health Hedi Chaker Hospital  Sfax Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amina","family":"Kammoun","sequence":"additional","affiliation":[{"name":"Departement of Rheumatology Hedi Chaker Hospital  Sfax Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7880-842X","authenticated-orcid":false,"given":"Zouhour","family":"Gassara","sequence":"additional","affiliation":[{"name":"Departement of Rheumatology Hedi Chaker Hospital  Sfax Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sofien","family":"Baklouti","sequence":"additional","affiliation":[{"name":"Departement of Rheumatology Hedi Chaker Hospital  Sfax 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