Rheumatoid arthritis is an autoimmune arthritis that has a predilection for small peripheral joints and the cervical spine. Although most patients commonly present with peripheral joint complaints, an estimable 43-50% of patients with cervical spine involvement are asymptomatic. The craniocervical junction is the most common cervical spine site of involvement and the atlanto-axial and the subaxial cervical spine may also be involved. Cervical instability is often diagnosed in patients undergoing unrelated procedures who are essentially asymptomatic and hence routine screening and radiological assessment of cervical instability in these patient is of importance. Complications related to cervical spine involvement are variable and may include cord compression, discitis, pathological fractures of the odontoid or erosions. Instability patterns of the cervical spine may occur and include atlanto-axial instability, basilar invagination and subaxial subluxation (8), with atlanto-axial instability being the most common.
Manuscripts that are Published Ahead of Print have been peer reviewed and accepted for publication by the Editorial Board of the West Indian Medical Journal. They may appear in their original format and may not be copy edited or formatted in the style guide of this Journal. While accepted manuscripts are not yet assigned a volume, issue or page numbers, they can be cited using the DOI and date of e-publication. See our Instructions for Authors on how to properly cite manuscripts at this stage. The contents of the manuscript may change before it is published in its final form. Manuscripts in this section will be removed once they have been issued to a volume and issue, but will still retain the DOI and date of e-publication.