{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T07:04:40Z","timestamp":1789196680734,"version":"build-2803163510"},"reference-count":34,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2005,2,1]],"date-time":"2005-02-01T00:00:00Z","timestamp":1107216000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Radiol"],"published-print":{"date-parts":[[2005,2]]},"abstract":"<jats:p>Purpose: Using flexion\/extension magnetic resonance imaging (MRI) with a dedicated positioning device, our purpose was to analyze pathologic cranio\u2010vertebral joint anatomy and motion in patients with rheumatoid arthritis in comparison to normal patients, and to compare flexion\/extension MRI with conventional radiographs (CRs) in patients with rheumatoid arthritis.<\/jats:p>\n                  <jats:p>Material and Methods: The 31 patients with rheumatoid arthritis and 20 healthy subjects included in the study were imaged in an open MRI scanner during flexion\/extension. A dedicated positioning device was used. Additionally, we compared flexion\/extension MRI with CRs in patients with rheumatoid arthritis. In MRI, the orientation and segmental motion of C0, C1, and C2 were assessed and structure of the dens and amount of pannus tissue were observed. Configuration of the cerebrospinal fluid space and the cord was evaluated in each position. In both MRI and CRs, anterior atlanto\u2010axial subluxation and vertical dislocation were assessed and sagittal diameter of the dural sac was measured.<\/jats:p>\n                  <jats:p>Results: In the neutral position, C1 of the patients was oriented in a more flexed position in relation to both C0 and C2 compared to that in healthy subjects. The patients had more extension in the upper cervical spine than did healthy subjects. In flexion, atlanto\u2010axial subluxation was greater in CRs than in MRI. In MRI, the amount of vertical dislocation did not depend on position. In the patients, there was considerably more cord impingement in flexion than in other positions.<\/jats:p>\n                  <jats:p>Conclusion: Evaluation of the rheumatoid cervical spine is optimized using MR images in the neutral, flexed, and extended positions. Measurements and relationships between structures should be compared in all positions. CRs with flexion\u2010extension views are recommended as the first imaging method.<\/jats:p>","DOI":"10.1080\/02841850510012012","type":"journal-article","created":{"date-parts":[[2006,2,21]],"date-time":"2006-02-21T12:23:54Z","timestamp":1140524634000},"page":"55-66","source":"Crossref","is-referenced-by-count":33,"title":["Evaluation of flexion\/extension of the upper cervical spine in patients with rheumatoid arthritis: an MRI study with a dedicated positioning device compared to conventional radiographs"],"prefix":"10.1177","volume":"46","author":[{"given":"J. O.","family":"Karhu","sequence":"first","affiliation":[{"name":"Department of Diagnostic Radiology, University of Turku and Turku University Hospital, Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. K.","family":"Parkkola","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, University of Turku and Turku University Hospital, Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. K.","family":"Koskinen","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, University of Turku and Turku University Hospital, Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2016,8,30]]},"reference":[{"key":"E00001","doi-asserted-by":"crossref","unstructured":"Allmann, K\u2010H, Uhl, M, Uhrmeister, P, Neumann, K, von Kempis, J, Langer, M. Functional MRI of the cervical spine in patients with rheumatoid arthritis. Acta Radiol, 1998; 39: 543\u20136","DOI":"10.1080\/02841859809172222"},{"key":"E00002","doi-asserted-by":"crossref","unstructured":"Bell, G. R, Stearns, K. L. Flexion\u2010extension MRI of the upper rheumatoid cervical spine. Orthopedics, 1991; 14: 969\u201373","DOI":"10.3928\/0147-7447-19910901-08"},{"key":"E00003","doi-asserted-by":"crossref","unstructured":"Boden, S. D, Dodge, L. D, Bohlman, H. H, Rechtine, G. R. Rheumatoid arthritis of the cervical spine. A long\u2010term analysis with predictors of paralysis and recovery. J Bone Joint Surg Am, 1993; 75: 1282\u201397","DOI":"10.2106\/00004623-199309000-00004"},{"key":"E00004","doi-asserted-by":"crossref","unstructured":"Bundschuh, C, Modic, M, Kearney, F, Morris, R, Deal, C. Rheumatoid arthritis of the cervical spine: surface\u2010coil MR imaging. Am J Roentgenol, 1988; 151: 181\u20137","DOI":"10.2214\/ajr.151.1.181"},{"key":"E00005","doi-asserted-by":"crossref","unstructured":"Dvorak, J, Grob, D, Baumgartner, H, Gschwend, N, Grauer, W, Larsson, S. Functional evaluation of the spinal cord by magnetic resonance imaging in patients with rheumatoid arthritis and instability of upper cervical spine. 1989; 14: 1057\u201364 Spine","DOI":"10.1097\/00007632-198910000-00006"},{"key":"E00006","unstructured":"Kauppi, M, Sakaguchi, M, Konttinen, Y. T, H\u00e4m\u00e4l\u00e4inen, M, Hakala, M. Pathogenetic mechanism and prevalence of the stable atlanto\u2010axial subluxation in rheumatoid arthritis. J Rheumatol, 1996; 23: 831\u20134"},{"key":"E00007","doi-asserted-by":"crossref","unstructured":"Kr\u00f6del, A, Refior, H. J, Westermann, S. The importance of functional MRI in the planning of stabilizing operations on the cervical spine in rheumatoid patients. Arch Orthop Trauma Surg, 1989; 109: 30\u20133","DOI":"10.1007\/BF00441906"},{"key":"E00008","doi-asserted-by":"crossref","unstructured":"McGregor, M. The significance of certain measurements of the skull in the diagnosis of basilar impression. Br J Radiol, 1948; 21: 171\u201381","DOI":"10.1259\/0007-1285-21-244-171"},{"key":"E00009","unstructured":"McRae, D. L, Barnum, A. S. Occipitalization of the atlas. Am J Roentgenol, 1953; 70: 23\u201346"},{"key":"E00010","doi-asserted-by":"crossref","unstructured":"Muhle, C, Metzner, J, Weinert, D, Schon, R, Rautenberg, E, Falliner, A, et al, . Kinematic MR imaging in surgical management of cervical disc disease, spondylosis and spondylotic myelopathy. Acta Radiol, 1999; 40: 146\u201353","DOI":"10.3109\/02841859909177730"},{"key":"E00011","doi-asserted-by":"crossref","unstructured":"Muhle, C, Resnick, D, Ahn, J, Sudmeyer, M, Heller, M. In vivo changes in the neural foraminal size at flexion\u2010extension and axial rotation of the cervical spine in healthy persons examined using kinematic magnetic resonance imaging. Spine, 2001; 26: e287\u201393","DOI":"10.1097\/00007632-200107010-00013"},{"key":"E00012","doi-asserted-by":"crossref","unstructured":"Muhle, C, Wiskirchen, J, Brinkmann, G, Falliner, A, Weinert, D, Reuter, M, et al, . Kinematic MRI in degenerative cervical spine changes. Rofo\u2010Fortschr Gebiet Rontgenstrahlen Bildgeb Verfahr, 1995; 163: 148\u201354","DOI":"10.1055\/s-2007-1015961"},{"key":"E00013","doi-asserted-by":"crossref","unstructured":"Muhle, C, Wiskirchen, J, Weinert, D, Falliner, A, Wesner, F, Brinkmann, G, et al, . Biomechanical aspects of the subarachnoid space and cervical cord in healthy individuals examined with kinematic magnetic resonance imaging. Spine, 1998; 23: 556\u201367","DOI":"10.1097\/00007632-199803010-00008"},{"key":"E00014","unstructured":"Pettersson, H, Larsson, E. M, Holtas, S, Cronqvist, S, Egund, N, Zygmunt, S, et al, . MR imaging of the cervical spine in rheumatoid arthritis. Am J Neuroradiol, 1988; 9: 573\u20137"},{"key":"E00015","doi-asserted-by":"crossref","unstructured":"Rana, N. A. Natural history of atlanto\u2010axial subluxation in rheumatoid arthritis. Spine, 1989; 14: 1054\u20136","DOI":"10.1097\/00007632-198910000-00005"},{"key":"E00016","doi-asserted-by":"crossref","unstructured":"Rana, N. A, Hancock, D. O, Taylor, A. R, Hill, A. G. S. Atlanto\u2010axial subluxation in rheumatoid arthritis. J Bone Joint Surg Br, 1973; 55: 458\u201370","DOI":"10.1302\/0301-620X.55B3.458"},{"key":"E00017","doi-asserted-by":"crossref","unstructured":"Redlund\u2010Johnell, I, Petterson, H. Vertical dislocation of the C1 and C2 vertebrae in rheumatoid arthritis. Acta Radiol, 1984; 25: 133\u201341","DOI":"10.1177\/028418518402500209"},{"key":"E00018","doi-asserted-by":"crossref","unstructured":"Stiskal, M. E, Neuhold, A, Szolar, D. H, Saeed, M, Czerny, C, Leeb, B, et al, . Rheumatoid arthritis of the craniocervical region by MR imaging: detection and characterization. Am J Roentgenol, 1995; 165: 585\u201392","DOI":"10.2214\/ajr.165.3.7645475"},{"key":"E00019","doi-asserted-by":"crossref","unstructured":"Tacke, J, Pfeffer, J. G, Glowinski, A, Birnbaum, K, Gunther, R. W. A smooth pneumatic motion device for dynamic MRI imaging of the cervical spine. Rofo\u2010Fortschr Gebiet Rontgenstrahlen Bildgeb Verfahr, 1999; 171: 249\u201353","DOI":"10.1055\/s-1999-250"},{"key":"E00020","doi-asserted-by":"crossref","unstructured":"Weissman, B. N, Aliabadi, P, Weinfeld, M. S, Thomas, W. H, Sosman, J. L. Prognostic feature of atlantoaxial subluxation in rheumatoid arthritis patients. Radiology, 1982; 144: 745\u201351","DOI":"10.1148\/radiology.144.4.7111719"},{"key":"E00021","doi-asserted-by":"crossref","unstructured":"Zeidman, S. M, Ducker, T. B. Rheumatoid arthritis. Neuroanatomy, compression and grading of deficits. Spine, 1994; 19: 2259\u201366","DOI":"10.1097\/00007632-199410150-00003"},{"key":"E00022","doi-asserted-by":"crossref","unstructured":"Ranawat, C. S, O'Leary, P, Pellici, P, Tsairis, P, Marchisello, P, Dorr, L. Cervical spine fusion in rheumatoid arthritis. J Bone Joint Surg Am, 1979; 61: 1003\u201310","DOI":"10.2106\/00004623-197961070-00006"},{"key":"E00023","doi-asserted-by":"crossref","unstructured":"Redlund\u2010Johnell, I, Petterson, H. Radiographic measurements of the cranio\u2010vertebral region. Acta Radiol, 1984; 25: 23\u20138","DOI":"10.1177\/028418518402500105"},{"key":"E00024","unstructured":"Casey, A, Crockard, H, Geddes, J, Stevens, J. Vertical translocation: the enigma of the disappearing atlantodens interval in patients with myelopathy and rheumatoid arthritis. Part I: Clinical, radiological and neuropathological features. J Neurosurg, 1997; 87: 856\u201362"},{"key":"E00025","unstructured":"Castro, S, Verstraete, K, Mielants, H, Vanderstraeten, G, De Reuck, J, Veys, E. M. Cervical spine involvement in rheumatoid arthritis: a clinical neurologic and radiological evaluation. Clin Exp Rheumatol, 1994; 12: 367\u201374"},{"key":"E00026","doi-asserted-by":"crossref","unstructured":"Karhu, J. O, Parkkola, R. K, Komu, M. E. S, Kormano, M. J, Koskinen, S. K. Kinematic MRI of the upper cervical spine using a novel positioning device. 1999; 24: 2046\u201356 Spine","DOI":"10.1097\/00007632-199910010-00015"},{"key":"E00027","doi-asserted-by":"crossref","unstructured":"Muhle, C, Brossmann, J, Biederer, J, Grimm, J, Mohr, A, Heller, M. Value of kinematic MRI in the evaluation of patients with exacerbated pain in cervical spine motion compared with static MRI. Rofo\u2010Fortschr Gebiet Rontgenstrahlen Bildgeb Verfahr, 2001; 126: 126\u201332","DOI":"10.1055\/s-2001-10896"},{"key":"E00028","doi-asserted-by":"crossref","unstructured":"N\u00e4gele, M von, Koch, W, Kaden, B, W\u00f6ll, B, Reiser, M. Dynamische funktions\u2010MRT der halswirbels\u00e4ule. Rofo\u2010Fortschr Gebiet Rontgenstrahlen Bildgeb Verfahr, 1992; 157: 222\u20138","DOI":"10.1055\/s-2008-1033003"},{"key":"E00029","unstructured":"Roca, A, Bernreuter, W, Alarcon, G. Functional MRI should be included in the evaluation of the cervical spine in patients with rheumatoid arthritis. J Rheumatol, 1993; 20: 1485\u20138"},{"key":"E00030","doi-asserted-by":"crossref","unstructured":"K\u00f6nig, H, Sieper, J, Wolf, K\u2010J. Rheumatoid arthritis: evaluation of hypervascular and fibrous pannus with dynamic MRI enhanced with Gd\u2010DTPA. Radiology, 1990; 176: 473\u20137","DOI":"10.1148\/radiology.176.2.2367663"},{"key":"E00031","doi-asserted-by":"crossref","unstructured":"Reiter, M. F, Boden, S. D. Inflammatory disorders of the cervical spine. 1998; 23: 2755\u201366 Spine","DOI":"10.1097\/00007632-199812150-00017"},{"key":"E00032","unstructured":"Santavirta, S, Kankaanp\u00e4\u00e4, U, Sandelin, J, Laasonen, E, Konttinen, Y. T, Sl\u00e4tis, P. Evaluation of patients with rheumatoid cervical spine. Scand J Rheumatol, 1987; 16: 9\u201316"},{"key":"E00033","unstructured":"Kauppi, M, Sakaguchi, M, Konttinen, Y. T, H\u00e4m\u00e4l\u00e4inen, M. A new method of screening for vertical dislocation. J Rheumatol, 1990; 17: 167\u201372"},{"key":"E00034","doi-asserted-by":"crossref","unstructured":"Reijnierse, M, Bloem, J, Dijkmans, B. A. C, et al, . The cervical spine in rheumatoid arthritis: relationship between neurologic signs and morphology on MRI and radiographs. Skeletal Radiol, 1996; 25: 113\u20138","DOI":"10.1007\/s002560050046"}],"container-title":["Acta Radiologica"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1080\/02841850510012012","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1080\/02841850510012012","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T13:46:34Z","timestamp":1777383994000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.sagepub.com\/doi\/10.1080\/02841850510012012"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,2]]},"references-count":34,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2005,2]]}},"alternative-id":["10.1080\/02841850510012012"],"URL":"https:\/\/doi.org\/10.1080\/02841850510012012","relation":{},"ISSN":["0284-1851","1600-0455"],"issn-type":[{"value":"0284-1851","type":"print"},{"value":"1600-0455","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,2]]}}}