Original Research

Simple Erosion Narrowing Score of the hands as a predictor of cervical spine subluxation in rheumatoid arthritis

Eric Gous, Mahmood M.T.M. Ally, Pieter W.A. Meyer, Farhana E. Suleman
South African Journal of Radiology | Vol 24, No 1 | a1876 | DOI: https://doi.org/10.4102/sajr.v24i1.1876 | © 2020 Eric Gous, Mahmood M.T.M. Ally, Pieter W.A. Meyer, Farhana E. Suleman | This work is licensed under CC Attribution 4.0
Submitted: 26 February 2020 | Published: 27 July 2020

About the author(s)

Eric Gous, Department of Radiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
Mahmood M.T.M. Ally, Department of Rheumatology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
Pieter W.A. Meyer, Department of Medical Immunology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
Farhana E. Suleman, Department of Radiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa


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Abstract

Background: Involvement of the cervical spine is common in patients with rheumatoid arthritis and can lead to devastating or even fatal consequences. Currently no guidelines exist as to whether radiographs of the cervical spine should be included in follow-up visits.

Objectives: To determine whether the Simple Erosion Narrowing Score (SENS) of the hands correlate with the presence of cervical spine subluxation in patients with rheumatoid arthritis.

Method: This was a retrospective, observational, cross-sectional study. A total of 56 rheumatoid arthritis patients with hand radiographs and lateral radiographs of the cervical spine were evaluated. The SENS of the hands and the presence of cervical spine subluxation were compared. The SENS of the hands was correlated with the prevalence of cervical spine subluxation, as was the erosion and joint space narrowing scores of the hands.

Results: A correlation between the SENS of the hands and the prevalence of cervical spine subluxation was confirmed. A higher prevalence of cervical spine subluxation correlated with an increase in the SENS of the hands (p = 0.0002). The erosion and joint space narrowing scores of the hands also correlated with the prevalence of cervical spine subluxation (p = 0.0001).

Conclusion: This study confirmed that a correlation exists between cervical spine subluxation, peripheral joint space erosions and joint space narrowing in patients with rheumatoid arthritis and SENS may therefore be used as a predictor of cervical spine disease.


Keywords

rheumatoid arthritis; SENS; cervical spine; subluxations; hands.

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