Odontoid fracture and C1-C2 subluxation in psoriatic cervical spondyloarthropathy. A case report.
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.
Sosner
J
J
Department of Physical Medicine, St. Vincent's Hospital and Medical Center of New York, USA.
Fast
A
A
Kahan
B S
BS
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