How do you approach patients referred for C1-2 pannus/erosions without clinical findings or serologies consistent with RA or CPPD arthropathy?

This is a most unusual clinical scenario. Rheumatologists are taught to image the C1-C2 area in patients with longstanding RA and persistent neck pain with or without accompanying myelopathic features. Therefore, a situation where the patient remains totally asymptomatic is quite uncommon.

In addit...

I agree with both Dr. Helfgott and Dr. Thomas, and would like to add the following:

Atlanto-Axial erosion/instability (AAI) can be caused by congenital causes and remote trauma that patient may not remember, as well. In such cases, you may see it as isolated involvement. Sporadic cases of pannus in ...

Non-Rheumatoid Seronegative Spondyloarthropathies: Conditions like ankylosing spondylitis or psoriatic arthritis can affect the spine without the presence of RF or CCP antibodies.

Infectious Causes: Such as tuberculosis (Pott’s disease) or other infectious agents that might involve the spine.

Neopla...