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Can neck pain be an initial symptom of rheumatoid arthritis? A case report and literature review

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Abstract

Although rheumatoid arthritis (RA) is most commonly associated with peripheral joints, cervical spine involvement can be seen in almost 80% of patients in the presence of long-term disease, joint erosion, and risk factors such as male sex and rheumatoid factor positivity. It is very rare to have cervical involvement in the initial period of RA. If a patient has isolated cervical spine involvement without peripheral arthritis, it is highly likely that inappropriate investigations and delayed treatment may occur. Any damage that occurs in cervical spine may cause symptoms varying from slight instability to atlantoaxial subluxation, spinal cord and brain stem compression and even death. Therefore, physician should be aware that there may be isolated cervical involvement, albeit rare, in patients with RA. In this report, we presented a case of RA presenting with cervical spine involvement without peripheral arthritis to underline the importance of this kind of involvement in clinical practice. We also briefly reviewed other cases similar to ours in light of literature.

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Authors and Affiliations

  1. Division of Rheumatology, Department of Internal Medicine, Eskişehir Osmangazi University, Eskisehir, Turkey

    Erdal Bodakçi, Döndü Üsküdar Cansu, Adem Ertürk & Cengiz Korkmaz

  2. Department of Radiology, Eskişehir Osmangazi University, Eskisehir, Turkey

    Cüneyt Çalişir

Authors
  1. Erdal Bodakçi
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  2. Döndü Üsküdar Cansu
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  3. Adem Ertürk
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  4. Cüneyt Çalişir
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  5. Cengiz Korkmaz
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Contributions

Study concept and design: EB, DUC and CK; analysis and interpretation of data: EB, DUC, AE, CÇ and CK; drafting of the manuscript: EB, AE and DUC; critical revision of the manuscript for important intellectual content: EB, DUC and CK; study supervision: EB, DUC, AE CÇ and CK.

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Correspondence to Döndü Üsküdar Cansu.

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The authors declare that there is no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Informed consent was obtained from our patient.

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Bodakçi, E., Üsküdar Cansu, D., Ertürk, A. et al. Can neck pain be an initial symptom of rheumatoid arthritis? A case report and literature review. Rheumatol Int 38, 925–931 (2018). https://doi.org/10.1007/s00296-018-4019-z

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  • DOI: https://doi.org/10.1007/s00296-018-4019-z

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