title: Odontoid fracture and C1-C2 subluxation in psoriatic cervical spondyloarthropathy. A case report.
abstract: METHODS
  Case presentation and review of pertinent literature.
  
  
  OBJECTIVE
  To present an unusual case and alert other physicians to possible missed diagnoses.
  
  
  BACKGROUND
  An unusual case is presented of a young man with server psoriatic spondyloarthropathy and fusion of C2-C7 (Type II cervical psoriatic ankylosing disease) who fell at home, sustaining an unrecognized fracture of the odontoid process leading to subluxation of C1-C2 and the transitory tetraplegia. The patient presented with torticollis, and the fracture was unrecognized for a long period of time.
  
  
  METHODS
  Case presentation.
  
  
  RESULTS
  This patient became independent in all activities of daily living after surgery and rehabilitation despite persistence of torticollis.
  
  
  CONCLUSIONS
  A patient who presents clinically with traumatic torticollis after minor trauma and who also has psoriasis and ankylosis of the cervical spine should be suspected of having a fracture-subluxation until definitely proven otherwise. In the present case, the late diagnosis delayed surgical stabilization.
authors.affiliation: Department of Physical Medicine, St. Vincent's Hospital and Medical Center of New York, USA.
authors.forename: J
authors.initials: J
authors.lastname: Sosner
authors.forename: A
authors.initials: A
authors.lastname: Fast
authors.forename: B S
authors.initials: BS
authors.lastname: Kahan
mesh_terms: D000328:Adult; D015535:Arthritis, Psoriatic / Q000150:complications* / Q000000981:diagnostic imaging; D003951:Diagnostic Errors; D006801:Humans; D004204:Joint Dislocations / Q000209:etiology*; D008297:Male; D009809:Odontoid Process / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D011859:Radiography; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D013167:Spondylitis, Ankylosing / Q000150:complications* / Q000000981:diagnostic imaging