Should children with Down syndrome be screened for atlantoaxial instability?
In 1995, the Committee on Sports Medicine and Fitness of the American Academy of Pediatrics (AAP) published a position paper on atlantoaxial instability in children with Down syndrome in which a previous statement on the same subject published in 1984 (Table) was retired. The 1995 statement includes several arguments that disfavor screening of children with Down syndrome for atlantoaxial instability. Whereas some of these arguments are well founded, other lack substantive evidence that would support the statement. In the following discussion, I attempt to analyze some of these arguments made in the 1995 statement and provide a viewpoint that favors radiologic examinations of the cervical spine of children with Down syndrome.
Pueschel
S M
SM
Child Development Center, Rhode Island Hospital, Providence, USA.
D001268:Atlanto-Axial Joint / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D004314:Down Syndrome / Q000150:complications* / Q000000981:diagnostic imaging*; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging* / Q000235:genetics; D008403:Mass Screening / Q000379:methods; D010372:Pediatrics; D017410:Practice Guidelines as Topic; D011859:Radiography; D012955:Societies, Medical; D013178:Sports Medicine; D014481:United States