<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2306-4102</journal-id>
<journal-title><![CDATA[Acta ortopédica mexicana]]></journal-title>
<abbrev-journal-title><![CDATA[Acta ortop. mex]]></abbrev-journal-title>
<issn>2306-4102</issn>
<publisher>
<publisher-name><![CDATA[Colegio Mexicano de Ortopedia y Traumatología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2306-41022018000600342</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[La severidad de la artritis reumatoide como predictor oportuno de inestabilidad de la columna cervical asintomática]]></article-title>
<article-title xml:lang="en"><![CDATA[The severity of rheumatoid arthritis as a timely predictor of instability in the asymptomatic cervical spine]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Geraldo-Flores]]></surname>
<given-names><![CDATA[NA]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Merlos-López]]></surname>
<given-names><![CDATA[RJ]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rodríguez-Wong]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ramírez-Hernández]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Espino-Lizarraga]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pérez-Atanasio]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto Mexicano del Seguro Social Hospital Regional 2 ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto Mexicano del Seguro Social Hospital Regional 2 ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Instituto Mexicano del Seguro Social Hospital Regional 2 Servicio de Columna]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Instituto Mexicano del Seguro Social Hospital Regional 2 Servicio de Columna]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Universidad del Valle de México  ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,Instituto Mexicano del Seguro Social Hospital Regional 2 ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2018</year>
</pub-date>
<volume>32</volume>
<numero>6</numero>
<fpage>342</fpage>
<lpage>346</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2306-41022018000600342&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2306-41022018000600342&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2306-41022018000600342&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción:  La afectación de la columna cervical es común en pacientes con artritis reumatoide (AR), factores de riesgo como la actividad de la enfermedad puede estar relacionada con inestabilidad cervical asintomática.  Objetivo:  Determinar los factores asociados a la inestabilidad de la columna cervical asintomáticos en pacientes con artritis reumatoide.  Material y métodos:  Estudio de casos y controles provenientes de la consulta externa de reumatología y columna de un centro de trauma de nivel II para identificar a todos los pacientes diagnosticados con AR e inestabilidad cervical asintomáticos. Con radiografías simples de la columna cervical que hacen mediciones radiográficas, se realizó el diagnóstico de inestabilidad cervical, se evaluaron los factores de riesgo como la presencia de factor reumatoide (FR), cirugías articulares previas, las elevaciones de los valores de proteína C reactiva (PCR), la severidad y actividad de la enfermedad medida en el índice de actividad de la enfermedad de 28 articulaciones (DAS 28), además del índice de actividad de la enfermedad simplificada (SDAI).  Resultados:  Se evaluaron 32 pacientes, nueve (28.1%) cumplieron con los criterios para inestabilidad de la columna cervical con subluxación atlantoaxial anterior (SAAa) (100%), también un paciente con SAAa presentaba subluxación vertical (SV), los factores de riesgo más relevantes: el DAS 28 con un OR = 3.54, SDA con un OR = 2.34 y por último el PCR &gt; 1.0 su OR = 2.88.  Conclusión:  Los factores de riesgo asociados oportunamente en nuestra población son la severidad de la actividad de la enfermedad que podemos observar en el DAS y SDAI al aplicarlos en los pacientes y PCR &gt; 1.0.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction:  Cervical spine involvement is common in patients with RA, risk factors such as disease activity may be related to asymptomatic cervical instability.  Objective:  To determine the associated factors for asymptomatic cervical spine instability in patients with rheumatoid arthritis.  Material and methods:  Case and control study from the external spine and rheumatology consultation of a level II trauma center to identify all patients diagnosed with rheumatoid arthritis (RA) and asymptomatic cervical instability. With simple X-rays of the cervical spine, carrying out radiographic measurements, the diagnosis of cervical instability was performed, risk factors such as the presence of rheumatoid factor (FR), previous articular surgeries, elevations of the C-reactive protein (PCR) values were evaluated. The severity and activity of the disease measured in the activity index of 28 articulations (DAS 28) in addition to the index of activity of the simplified disease (SDAI).  Results:  We assessed 32 patients, nine patients (28.1%) met the criteria for instability of the anterior cervical spine atlantoaxial subluxation (SAAa) (100%), also one patient with SAAa presented vertical subluxation (SV), risk factors more relevant: DAS 28 with an OR = 3.54, SDA with an OR = 2.34 and finally the PCR &gt; 1.0 its OR = 2.88.  Conclusion:  The risk factors associated opportunely in our population are the severity of the activity of the disease that we can see in the DAS and SDAI when applied in patients and PCR &gt; 1.0.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Columna cervical]]></kwd>
<kwd lng="es"><![CDATA[inestabilidad]]></kwd>
<kwd lng="es"><![CDATA[artritis reumatoide]]></kwd>
<kwd lng="es"><![CDATA[articulación atlantoaxial]]></kwd>
<kwd lng="es"><![CDATA[factores de riesgo]]></kwd>
<kwd lng="en"><![CDATA[Cervical spine]]></kwd>
<kwd lng="en"><![CDATA[instability]]></kwd>
<kwd lng="en"><![CDATA[rheumatoid arthritis]]></kwd>
<kwd lng="en"><![CDATA[atlantic-axial articulation]]></kwd>
<kwd lng="en"><![CDATA[risk factors]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ma&#324;czak]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Gasik]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cervical spine instability in the course of rheumatoid arthritis - imaging methods]]></article-title>
<source><![CDATA[Reumatologia]]></source>
<year>2017</year>
<volume>55</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>201-7</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kaito]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Ohshima]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Fujiwara]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Makino]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Yonenobu]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Predictors for the progression of cervical lesion in rheumatoid arthritis under the treatment of biological agents]]></article-title>
<source><![CDATA[Spine (Phila Pa 1976)]]></source>
<year>2013</year>
<volume>38</volume>
<numero>26</numero>
<issue>26</issue>
<page-range>2258-63</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Del Grande]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Del Grande]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Carrino]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Bingham]]></surname>
<given-names><![CDATA[CO]]></given-names>
</name>
<name>
<surname><![CDATA[Louie]]></surname>
<given-names><![CDATA[GH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cervical spine involvement early in the course of rheumatoid arthritis]]></article-title>
<source><![CDATA[Semin Arthritis Rheum]]></source>
<year>2014</year>
<volume>43</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>738-44</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kaito]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Hosono]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Ohshima]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Ohwaki]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Takenaka]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Fujiwara]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Effect of biological agents on cervical spine lesions in rheumatoid arthritis]]></article-title>
<source><![CDATA[Spine (Phila Pa 1976)]]></source>
<year>2012</year>
<volume>37</volume>
<numero>20</numero>
<issue>20</issue>
<page-range>1742-6</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Na]]></surname>
<given-names><![CDATA[MK]]></given-names>
</name>
<name>
<surname><![CDATA[Chun]]></surname>
<given-names><![CDATA[HJ]]></given-names>
</name>
<name>
<surname><![CDATA[Bak]]></surname>
<given-names><![CDATA[KH]]></given-names>
</name>
<name>
<surname><![CDATA[Yi]]></surname>
<given-names><![CDATA[HJ]]></given-names>
</name>
<name>
<surname><![CDATA[Ryu]]></surname>
<given-names><![CDATA[JI]]></given-names>
</name>
<name>
<surname><![CDATA[Han]]></surname>
<given-names><![CDATA[MH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Risk factors for the development and progression of atlantoaxial subluxation in surgically treated rheumatoid arthritis patients, considering the time interval between rheumatoid arthritis diagnosis and surgery]]></article-title>
<source><![CDATA[J Korean Neurosurg Soc]]></source>
<year>2016</year>
<volume>59</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>590-6</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cha]]></surname>
<given-names><![CDATA[TD]]></given-names>
</name>
<name>
<surname><![CDATA[An]]></surname>
<given-names><![CDATA[HS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cervical spine manifestations in patients with inflammatory arthritides]]></article-title>
<source><![CDATA[Nat Rev Rheumatol]]></source>
<year>2013</year>
<volume>9</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>423-32</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Terashima]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Yurube]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Hirata]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Sugiyama]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Sumi]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Predictive risk factors of cervical spine instabilities in rheumatoid arthritis: a prospective multicenter over 10-year cohort study]]></article-title>
<collab>Hyogo Organization of Spinal Disorders</collab>
<source><![CDATA[Spine (Phila Pa 1976)]]></source>
<year>2017</year>
<volume>42</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>556-64</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zhu]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Xu]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Luo]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Zhao]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Liu]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cervical spine involvement risk factors in rheumatoid arthritis: a meta-analysis]]></article-title>
<source><![CDATA[Int J Rheum Dis]]></source>
<year>2017</year>
<volume>20</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>541-9</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Han]]></surname>
<given-names><![CDATA[MH]]></given-names>
</name>
<name>
<surname><![CDATA[Ryu]]></surname>
<given-names><![CDATA[JI]]></given-names>
</name>
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[CH]]></given-names>
</name>
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Cheong]]></surname>
<given-names><![CDATA[JH]]></given-names>
</name>
<name>
<surname><![CDATA[Bak]]></surname>
<given-names><![CDATA[KH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Factors that predict risk of cervical instability in rheumatoid arthritis patients]]></article-title>
<source><![CDATA[Spine (Phila Pa 1976)]]></source>
<year>2017</year>
<volume>42</volume>
<numero>13</numero>
<issue>13</issue>
<page-range>966-73</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Collins]]></surname>
<given-names><![CDATA[DN]]></given-names>
</name>
<name>
<surname><![CDATA[Barnes]]></surname>
<given-names><![CDATA[CL]]></given-names>
</name>
<name>
<surname><![CDATA[FitzRandolph]]></surname>
<given-names><![CDATA[RL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cervical spine instability in rheumatoid patients having total hip or knee arthroplasty]]></article-title>
<source><![CDATA[Clin Orthop Relat Res]]></source>
<year>1991</year>
<numero>272</numero>
<issue>272</issue>
<page-range>127-35</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nazarinia]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Jalli]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Kamali-Sarvestani]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Farahangiz]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Ataollahi]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Asymptomatic atlantoaxial subluxation in rheumatoid arthritis]]></article-title>
<source><![CDATA[Acta Med Iran]]></source>
<year>2014</year>
<volume>52</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>462-6</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Neva]]></surname>
<given-names><![CDATA[MH]]></given-names>
</name>
<name>
<surname><![CDATA[Häkkinen]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Mäkinen]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Hannonen]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Kauppi]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Sokka]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[High prevalence of asymptomatic cervical spine subluxation in patients with rheumatoid arthritis waiting for orthopaedic surgery]]></article-title>
<source><![CDATA[Ann Rheum Dis]]></source>
<year>2006</year>
<volume>65</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>884-8</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zhang]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Pope]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cervical spine involvement in rheumatoid arthritis over time: results from a meta-analysis]]></article-title>
<source><![CDATA[Arthritis Res Ther]]></source>
<year>2015</year>
<volume>17</volume>
<page-range>148</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
