Prevalence of and Risk Factors for the Progression of Upper Cervical Lesions in Patients with Rheumatoid Arthritis

Masahiro Horita, Keiichiro Nishida, Kenzo Hashizume, Yoshihisa Sugimoto, Yoshihisa Nasu, Ryuichi Nakahara, Ryozo Harada, Toshifumi Ozaki

Research output: Contribution to journalArticle


We investigated the prevalence of and risk factors for the progression of upper cervical lesions (UCLs) in patients with rheumatoid arthritis (RA). A retrospective analysis of 49 patients with RA (4 males, 45 females) was conducted. The UCLs included atlanto-axial subluxation and vertical subluxation. We investigated the clinical factors including the Disease Activity Score 28 based on C-reactive protein (DAS28-CRP) and the modified Health Assessment Questionnaire-Disability Index as well as radiographic changes between the baseline (at May 2010 to April 2013) and final follow-up. Forty patients (81.6%) were classified as the non-progressive group, and the other 9 patients (18.4%) comprised the progressive group. The progressive group's final CRP values, baseline or final MMP-3 levels, DAS28-CRP, and rate of pre-existing lesions at baseline were all significantly higher than those of the non-progressive group (p=0.017, p=0.043, p=0.002, p=0.008, p<0.001, and p=0.008 respectively). A multivariate logistic regression analysis demonstrated that DAS28-CRP at baseline was a risk factor for radiographic progression (p=0.018, odds ratio: 2.54, 95% confidence interval: 1.17-5.51). Our findings indicate that higher disease activity might influence the progression of UCLs in patients with RA.

Original languageEnglish
Pages (from-to)235-240
Number of pages6
JournalActa medica Okayama
Issue number3
Publication statusPublished - Jun 1 2019


  • radiological progression
  • rheumatoid arthritis
  • risk factor
  • upper cervical spine lesion

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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