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Pathogenesis of cervical discovertebral destruction in rheumatoid arthritis.

A review of 20 cases of rheumatoid arthritis strongly supported the concept that the cervico-disco-vertebral destruction seen radiologically is a consequence of cervical instability caused by apophyseal arthritis and ligamentous laxity. It is postulated that such instability results in chronic trauma to the discovertebral joints leading to destruction of the disc cartilage and vertebral endplates. "Rheumatoid inflammation" of the disc has previously been described, but it is uncertain that such inflammation in the disc is the primary cause of these destructive lesions.