Rheumatoid and other diseases of the cervical interspinous bursae, and changes in the spinous processes

Abstract

Bursal spaces between the cervical interspinous processes were found at necropsy in 14 out of 27 'normal' adult necks, especially when the spines were close together. In this random series they were the seat of crystallopathic disease in 2 instances out of 14 cases. In spines from 9 cases of adult-onset rheumatoid arthritis, rheumatoid bursitis was seen in 2 and banal bursitis in 2. In juvenile-onset chronic arthritis inflammatory bursal changes of a rheumatoid nature were found in 2 out of 5 cases, and are compared with the 'normal'. A third case showed crystallopathic destruction. In one instances of adult RA very severe changes were seen, with destruction of the spinous processes, and this was associated with hypermobile segments dependent on discal destruction starting in the oncovertebral joints. An association is described between discal lesions, spinous erosion, enthesopathy, and interspinous bursitis.