Functional magnetic resonance imaging should be included in the evaluation the cervical spine in patients with rheumatoid arthritis.

OBJECTIVE: To determine the value of functional (flexion) magnetic resonance imaging (MRI) studies in patients with rheumatoid arthritis (RA) suspected of having cervical (C)-spine involvement.

METHODS: Four patients with RA suspected of having C spine involvement, with neurological symptoms and/or signs, and who had normal MRI in neutral position, underwent functional MRI.

RESULTS: In all 4 patients functional MRI provided additional information. Cord compression (3 patients) and angulation of the cord (1 patient) were evident only in this view.

CONCLUSION: Functional MRI provided additional information in these patients and may be indicated in patients with RA suspected of having C spine involvement who have a normal MRI study in a neutral position.