Atlantoaxial instability (AAI) in rheumatoid arthritis – Is the patient at risk during endoscopy of the upper GI tract?

Introduction: Rheumatoid arthritis (RA) of the cervical spine joints affects up to 40% of patients with long-standing disease. The use of non-steroidal antirheumatic drugs is associated with increased rates of upper gastrointestinal disease, which require endoscopic evaluation. Arthritis/Deformation of the cervical spine has been described as a particular hazard for endoscopists. However, data regarding the specific risks of esophago-gastroduodenoscopy (EGD) in patients with AAI are lacking. Objectives: The history of patients with RA/AAI was analyzed retrospectively to evaluate specific risks of EGD. Methods: D…