title: Septic arthritis of the atlantoaxial joint: case report.
abstract: Bacterial epidural abscess formation of cervical spine was rarely seen and all these cases were associated with osteomyelitis of the odontoid process. To the author's knowledge, only 1 case of septic arthritis of the C1-C2 lateral facet joint has been reported in the English literature. A 76-year-old woman presented with progressive neck pain and stiffness in the left side of her neck with fever. Coronal computed tomography clearly demonstrated destructive change of the atlantoaxial joint. Contrast magnetic resonance imaging demonstrated infection of the atlantoaxial joint resulting in epidural abscess formation. Because of lack of neurologic deficit, we treated her with halo-fixation together with appropriate antibiotics administration. The patient was successfully treated with antibiotics and immobilization. Septic arthritis of the lateral atlantoaxial joint should be added to the differential diagnosis of severe neck pain with fever, although it is very rare clinical entity. Early analysis of computerized tomography and magnetic resonance imaging although maintaining a high suspicion for this disease is mandatory to avoid delayed diagnosis and subsequent morbidity.
authors.affiliation: Department of Orthopaedic Surgery, Himeji St Mary's Hospital, Himeji, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Sasaki
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nabeshima
authors.forename: Akihiro
authors.initials: A
authors.lastname: Ozaki
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Mori
authors.forename: Hideo
authors.initials: H
authors.lastname: Fujii
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Sumi
authors.forename: Minoru
authors.initials: M
authors.lastname: Doita
mesh_terms: D000368:Aged; D001170:Arthritis, Infectious / Q000175:diagnosis* / Q000628:therapy; D001268:Atlanto-Axial Joint / Q000382:microbiology*; D005260:Female; D006801:Humans; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000628:therapy