http://www.medilaw.tv Cervical Spine Pathology Rheumatoid Spondylitis rheumatologist movies. Shows the natural progression of cervical facet joint rheumatoid spondylitis. The pathology illustrated includes synovitis, joint effusion, pannus formation and ingrowth, articular cartilage degradation, osteopenia, peri-articular bone cysts and joint subluxation.
RHEUMATOID ARTHRITIS
Rheumatoid arthritis is a long-term inflammatory disease of the whole body. The cause is unknown, but theories include combinations of viral infection, genetic predisposition, psychological stress, hormone interactions and autoimmune dysfunction - where a person's immune system begins to attack their own body. Rheumatoid arthritis primarily involves the knuckle joints of the feet and hands. The next most commonly affected region is the cervical spine. The thoracic and lumbar spine are rarely affected. Rheumatoid spondylitis refers to the inflammation and destruction of synovial joints and the adjacent ligaments and bone in the spine. Cervical Spine Pathology Rheumatoid Spondylitis rheumatologist movies.
Rheumatoid spondylitis can affect any level of the cervical spine and begins early, with 80% of clients developing cervical instability within two years of the onset of the disease.
Damage to the supporting joint surfaces, ligaments and muscles allows abnormal movement of the spine joints. This instability or lack of proper alignment between adjacent vertebrae places pressure on the spinal cord or the nerves as they leave the spinal cord. This can cause pain, numbness or weakness that is the major medical concern for clients with rheumatoid spondylitis.
Rheumatoid spondylitis starts with the cells in the synovial membrane, or synovium, lining the synovial joints. When stimulated, the cells produce a substance that triggers an inflammatory response from the body, causing it to attack the synovium. This inflammatory response in turn causes the growth of swollen granulation tissue, known as rheumatoid pannus, within the synovium.
The pannus makes enzymes that destroy adjacent cartilage, ligaments, tendons, and bone. Their destruction leads to loose or ruptured ligaments and bony erosion, which combined with muscle weakness and tendinitis, leads to joint instability and the incorrect alignment of joint surfaces, known as subluxationEventually, little articular cartilage remains and osteoarthritis develops. This condition can be accompanied with thinning of the adjacent bone, known as osteopenia.
Rheumatoid spondylitis can lead to :
erosive synovitis - where the inflamed synovium destroys the adjacent articular cartilage, the underlying bone and the adjacent ligaments
ligamentous subluxation - where the stretched and ruptured ligaments fail to support the joint, and the two joint surfaces slide across each other in an abnormal way
osteopenia - where the underlying bone thins and loses its strength, and
vertebral body fracture - where the weakened bone fractures, often under minimal stress. Cervical Spine Pathology Rheumatoid Spondylitis rheumatologist movies.
DEFORMITIES
Rheumatoid deformities of the cervical spine can be categorized in three groups:
atlanto-axial subluxation or instability
cranial settling (also known as superior migration of the odontoid, pseudobasilar invagination, vertical / upward translocation of the odontoid)
subaxial subluxation.
Any combination of these deformities can occur.
Subaxial subluxation occurs when erosion of the facet joints, intervertebral discs and interspinous ligaments of the third to seventh cervical vertebrae leads to slipping and mal-alignment between adjacent vertebrae. This happens in up to 20% of rheumatoid spondylitis patients, and can occur at multiple levels, producing a stepladder deformity of adjacent vertebra.
While neck pain is seen in up to 90% of people with rheumatoid spondylitis, only a third develop nerve impairment due to pressure on the spinal cord or spinal nerves. Spinal cord or nerve compression are the main reasons for surgery, which is used to remove the tissues compressing the nerves and return the spinal alignment to normal.
While neck pain is seen in up to 90% of people with rheumatoid spondylitis, only a third develop nerve impairment due to pressure on the spinal cord or spinal nerves. Spinal cord or nerve compression are the main reasons for surgery, which is used to remove the tissues compressing the nerves and return the spinal alignment to normal. Cervical Spine Pathology Rheumatoid Spondylitis rheumatologist movies.
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