Dysphagia as an initial complaint in rheumatoid arthritis is rare. We describe the case of a 69-year-old woman with rheumatoid arthritis who presented with a 2-day history of acute dysphagia. Our evaluation revealed the cause of the dysphagia was the presence of rheumatoid pannus that involved the anterior cervical spine and compressed the esophagus. Although the otolaryngologic manifestations of rheumatoid arthritis usually relate to synovial involvement of the temporomandibular and cricoarytenoid joints, our case establishes that a rheumatoid pannus on the anterior cervical spine can cause dysphagia. We believe that this may be the first reported case of this clinical entity.
References
1.
KraneSM, SimonLS. Rheumatoid arthritis: Clinical features and pathogenetic mechanisms. Med Clin North Am1986;70:263–84.
2.
GowPJ, GibsonT.Dysphagia due to vertical subluxation of the axis in rheumatoid arthritis. Rheumatol Rehabil1977;16:155–7.
3.
PearsonME, KoscoM, HufferW, Rheumatoid nodules of the spine: Case report and review of the literature. Arthritis Rheum1987;30:709–13.
4.
LawryGV, FinermanML, HanafeeWN, Laryngeal involvement in rheumatoid arthritis: A clinical, laryngoscopic, and computerized tomographic study. Arthritis Rheum1984;27:873–82.
5.
RanaNA, HancockDO, TaylorAR, HillAG. Atlanto-axial subluxation in rheumatoid arthritis. J Bone Joint Surg1973;55:458–70.
6.
CrellinRQ, MaccabeJJ, HamiltonEB. Severe subluxation of the cervical spine in rheumatoid arthritis. J Bone Joint Surg1970;52:244–51.
7.
MeijersKA, van BeusekomGT, LuyendijkW, DuijfjesF.Dislocation of the cervical spine with cord compression in rheumatoid arthritis. J Bone Joint Surg1974;56:668–80.
8.
SmithPH, BennRT, SharpJ.Natural history of rheumatoid cervical luxations. Ann Rheum Dis1972;31:431–9.
9.
EkbergO, Redlund-JohnellI, SjoblomKG. Pharyngeal function in patients with rheumatoid arthritis of the cervical spine and temporomandibular joint. Acta Radiol1987;28:35–9.
