Rheumatoid arthritis is the most common inflammatory rheumatism. Cervical spine involvement in rheumatoid arthritis is a frequent and potentially serious complication.
Objectives:
The objective of our study is to investigate the correlation between cervical spine involvement in RA and anti-citrullinated protein antibodies (ACPA).
Methods:
Our work is a retrospective descriptive and analytical study involving patients followed in our department for RA meeting the ACR 1987 and/or ACR/EULAR criteria over a period from January 2020 to December 2023. We collected deographic, clinical, radiological, and therapeutic data and studied the correlation between cervical spine involvement in RA and ACPA.
Results:
A total of 437 patients were included. The mean age was 58.68 ± 12.44 years with a female predominance: 85.8% females and 14.2% males. Diabetes was present in 19.1%, and hypertension in 16%. The average duration of RA was 14.7 ± 7.591 years. The mean rheumatoid factor (RF) was 170.25 ± 283.02, and the mean ACPA was 230.50 ± 435.99. In our study, we had two groups: The first group without cervical involvement (55.4% of cases) with a mean onset age of 43.29 ± 14.05, a mean diagnosis delay of 37.18 ± 44.91 months, RF positive in 84.1%, ACPA positive in 65.8%, mean DAS28 CRP was 5.01 ± 1.45, and HAQ >0.5 in 74.9%. The second group with cervical involvement (44.66% of cases) had a mean disease onset age of 44.34 ± 12.59 (P=0.420), a diagnosis delay of 52.12 ± 71.56 months (P=0.009), RF positive in 83% of cases (P=0.795), ACPA positive in 61.8% (P=0.414), mean DAS28 CRP was 5.71± 3.31 (P=0.004), and HAQ > 0.5 in 76.8% (P=0.723).
Conclusion:
Through this study, we observed that cervical involvement is common in RA. ACPA has prognostic value for RA but is not associated with cervical spine involvement. However, there is a significant association between cervical involvement and a high DAS CRP, as well as a late diagnostic delay.