A 32 old man with past history of joint swelling



Doctor's Information

Name : Maryam
Family :Noori
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : ----------------


Patient's Information

Gender : Male
Age : 32


Case Section

Head & Neck Imaging


Clinical Summary

A 32 year old man with recent onset of myelopathy



Imaging Procedures and Findings

A 32 year old man with a past history of swelling in joints, morning pain & stiffness, presented with progressive radiculopathy in cervical spine & myelopathy. Performed MRI revealed diffuse discovertebral osteodegenerative changes especially from C2 to C6 levels associated with basilar invagination , atlanto-axial subluxation & erosion of odontoid process caused by a mass like lesion with predominantly low intensity on T1 & T2w (pannus). You can see cord compression, also high signal intensity in cervical cord related to myelomalacia



Cervical spine involves in approximately 60% of RA patients. C1-C2 instability is noted in 33% of all RA patients but in 5% of all RA cases AAS is seen. Using MRI on Tlw pannus is low signal intensity, mass-like lesion, also we can see erosions. On T2w pannus is heterogeneous signal intensity contained low signal areas may mimic pigmented villonodular synovitis (PVNS). Bone marrow edema& facet joint effusions are also common. Cord may be compressed by pannus. T1 with contrast is used in early diagnosis of RA because pannus enhances avidly.


Final Diagnosis

Atlanto-axial subluxation, basilar invagination & myelomalacia (RA)



Diagnostic Imaging Spine, Ross and Moore et al. Fundamental of diagnostic radiology, William E. Brant, Clyde A. Helms.


end faqaq


Go to top