title: Atlantoaxial rotatory fixation secondary to tuberculosis of occiput: a case report.
abstract: 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.
authors.affiliation: Department of Orthopaedics, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India. dhaon@nde.vsnl.net.in
authors.forename: B K
authors.initials: BK
authors.lastname: Dhaon
authors.forename: Anuj
authors.initials: A
authors.lastname: Jaiswal
authors.forename: Vishal
authors.initials: V
authors.lastname: Nigam
authors.forename: Vineet
authors.initials: V
authors.lastname: Jain
mesh_terms: 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
chemical_list: D000995:Antitubercular Agents