{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T12:51:08Z","timestamp":1776084668770,"version":"3.50.1"},"reference-count":42,"publisher":"The Journal of Rheumatology","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"accepted":{"date-parts":[[2025,10,14]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aimed to investigate the prevalence and incidence of atlantoaxial subluxation (AAS) in psoriatic arthritis (PsA), identify associated risk factors, and describe the clinical and radiographic characteristics of affected patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included individuals from our observational cohort of PsA, excluding those with a history of trauma or cervical spine surgery. We calculated prevalence and incidence of AAS, and we used descriptive statistics to summarize and compare baseline demographic and disease-related characteristics between patients with and without AAS. Additionally, we used Cox regression with time-varying covariates to identify factors linked to AAS development and performed multivariable generalized estimating equations (GEE) analysis to assess associations with AAS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 1535 patients with PsA, 34 (2.21%) were identified with AAS, including 20 at baseline and 14 during follow-up, with an incidence of 1.16 per 1000 person-years. Patients with AAS had higher rates of radiographic sacroiliitis (64.71%) and greater peripheral joint damage. Elevated erythrocyte sedimentation rate (ESR) was observed in 84.85% of cases. Cox regression identified radiographic sacroiliitis (hazard ratio [HR] 6.61, 95% CI 1.64-26.67) as the strongest predictor of AAS, whereas male sex was associated with a lower hazard (HR 0.25, 95% CI 0.07-0.89). In GEE analysis, radiographic sacroiliitis (odds ratio [OR] 3.64, 95% CI 1.61-8.24) and higher modified Steinbrocker scores (OR 1.01, 95% CI 1.00-1.02) were associated with AAS, whereas older age (OR 0.95, 95% CI 0.92-0.98) and male sex (OR 0.40, 95% CI 0.17-0.92) were associated with lower ORs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>AAS is an uncommon complication in PsA strongly associated with radiographic sacroiliitis and radiographic damage in peripheral joints.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3899\/jrheum.2025-0475","type":"journal-article","created":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T12:25:24Z","timestamp":1761999924000},"page":"271-276","source":"Crossref","is-referenced-by-count":1,"title":["Atlantoaxial Subluxation in Patients With Psoriatic 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