One hundred and twenty-one patients with juvenile rheumatoid arthritis
were studied clinically and roentgenographically for evidence of disease of
the cervical spine. None of the fifty-seven patients with
pauciarticular-onset juvenile rheumatoid arthritis had cervical symptoms or
signs, and only one had minor roentgenographic changes of disease in the
cervical spine. In contrast, clinical stiffness and roentgenographic
changes in the cervical spine occurred commonly in the fifty-one patients
with polyarticular-onset disease and in the thirteen patients with
systemic-onset disease. Despite extensive roentgenographic involvement of
the cervical spine, however, pain in the neck was not a common complaint.
Neither severe pain in the neck nor torticollis, occurring either
separately or concomitantly, is frequently found in patients with juvenile
rheumatoid arthritis, and its presence may suggest an intercurrent problem
such as a fracture or infection. As patients with juvenile rheumatoid
arthritis rarely have disease in the cervical spine alone, the patient
should be carefully examined for involvement of multiple joints.