الفهرس 
INTRODUCTION AND AIM OF THE WORKOnly 14 pages are availabe for public view
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Abstract
heumatoid arthritis (RA) is a common systemic autoimmune disorder of unknown etiology (Mollar;! 998).
The cervic~l spine is the common focus of destruction from rheumatoid arthritis, and the results instability and neural compression are the most common complications (Lipson; 1989 and Lipson; 1985).
The present study included 100 patients with rheumatoid arthritis disease according to ARA Revised Criteria;! 987(Arnett et al;1988) and 20 apparently healthy controls, the studied patients were 15 males (150/0) and 85 females(85%) ranging in age from 6- 73 with a mean ± SD of 40.l± 12.9. They were subdivided into 2 group patients with and without cervical subluxation as diagnosed by CT and X ray.
All patients and control groups were subjected to history taking, clinical examination, and routine investigations for confmning the diagnosis. C- T examination at the level of upper cervical spine was done and lateral view of the cervi~al spine in complete flexion, extension, neutral, open mouth view p1aip X ray were taken.
There was a significant difference between patients with and
without subluxation as regarding duration of the disease, neurological deficit, vertebro-basilar artery compression, rheumatoid nodule, severity
The prevalence of total subluxation was 40% by CT and 37% by X ray, and the anterior atlantoaxial subluxation is more frequent followed by lateral of the’ disease , restriction of neck movement(rotation) and usage of steroid therapy.
There was a positive correlation between total subluxation as diagnosed by CT, X ray and duration of the disease, neurological deficits, vertebral artery compression , rheumatoid nodule, limitation of rotation movement of the neck and usage of steroid therapy.
The sensitivity and specificity of X ray to CT in diagnosis of allterior AAS in RA patients was 100%, but The sensitivity and specificity of X ray to CT in diagnosis of lateral AAS in RA patients was 77.2 % to 100 %.
Recommendations
• Routine plain cervical X ray (lateral view with full flexion extension, open mouth view) for each rheumatoid arthritis patient must be done.
• C-T with contrast media, can be particularly useful for demonstrating spinal cord compression .