Atlantoaxial dislocation as the presenting symptom of ankylosing spondylitis.
A 27-year-old woman presented with nontraumatic atlantoaxial dislocation that required a C1-C2 fusion. A comprehensive investigation initially failed to reveal any evidence of infectious or rheumatologic disease and she remained well for 3 1/2 years, at which time a diagnosis of ankylosing spondylitis was established. There are no other similar cases reported in the medical literature. When dealing with a patient who has experienced a spontaneous atlantoaxial dislocation, a thorough assessment looking for an underlying infectious or inflammatory etiology is mandatory. Furthermore, the authors recommend that any patient who has negative investigations be followed long-term; an underlying covert inflammatory cause may only become evident after significant delay.
Hamilton
M G
MG
Department of Clinical Neurosciences, University of Calgary, Alberta, Canada.
MacRae
M E
ME
D000328:Adult; D001268:Atlanto-Axial Joint; D001368:Axis, Cervical Vertebra / Q000601:surgery; D001270:Cervical Atlas / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D004204:Joint Dislocations / Q000209:etiology* / Q000601:surgery; D013123:Spinal Fusion; D013167:Spondylitis, Ankylosing / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D013997:Time Factors