Atlantoaxial rotatory fixation secondary to tuberculosis of occiput: a case report.
METHODS
A case of nontraumatic rotatory fixation of the atlantoaxial joint associated with tuberculosis of the occipital bone in an adult.


OBJECTIVE
To report a rare case of atlantoaxial rotatory subluxation associated with tuberculosis of the occipital bone in an adult and to discuss the mechanism of fixation.


BACKGROUND
Atlantoaxial rotatory fixation in adults is rare and has been reported due to variety of causes. To the authors' best knowledge no case has been reported secondary to tuberculosis of the skull bone.


METHODS
A 20-year-old male presented with resistant torticollis with a duration of 5 months.


RESULTS
The patient had type 1 atlantoaxial rotatory fixation secondary to tuberculosis of the occipital bone. The subluxation was partially reduced by conservative means, and healing of the occiput lesion was achieved. Thereafter, the patient had no restriction of cervical spine motion and had no reoccurrence of subluxation at a follow-up of one and a half years.


CONCLUSIONS
Effusion in the atlantoaxial joint secondary to infection in the occiput due to close proximity with the joint led to the laxity of ligaments and contributed to the subluxation.
Dhaon
B K
BK
Department of Orthopaedics, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India. dhaon@nde.vsnl.net.in
Jaiswal
Anuj
A
Nigam
Vishal
V
Jain
Vineet
V
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D001268:Atlanto-Axial Joint / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005334:Fever / Q000209:etiology; D006801:Humans; D008297:Male; D009333:Neck / Q000000981:diagnostic imaging; D009777:Occipital Bone / Q000000981:diagnostic imaging*; D016059:Range of Motion, Articular; D014057:Tomography, X-Ray Computed; D014103:Torticollis / Q000175:diagnosis / Q000209:etiology; D014143:Traction; D014376:Tuberculosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy
D000995:Antitubercular Agents