title: Cervical instability presenting as thoracic pain: case report and literature review.
abstract: METHODS
  Case report.
  
  
  OBJECTIVE
  To report a case of cervical instability from an os odontoideum that presented as posterior thoracic pain and to present a review of the literature.
  
  
  BACKGROUND
  Thoracic posterior paraspinal spasms  and pain are common chief complaints in individuals with spinal abnormalities.
  
  
  METHODS
  A 19-year-old man presented with posterior thoracic pain for nearly 1 year following a college sports-related injury (lacrosse). Computed tomography and magnetic resonance imaging did  not reveal any significant thoracic or lumbar spinal cord or nerve root pathology, but did reveal an incidental finding of an os odontoideum.
  
  
  RESULTS
  Surgical stabilization of the atlantoaxial instability resulting from the os odontoideum resulted in complete resolution  of the patient's thoracic pain.
  
  
  CONCLUSIONS
  Thoracic back pain without a clear thoracic spine etiology warrants further workup to rule out the possibility of spinal instability.
authors.affiliation: Jefferson Medical College, Philadelphia, PA, USA.
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Zussman
authors.forename: Nelson S
authors.initials: NS
authors.lastname: Saldua
authors.forename: James S
authors.initials: JS
authors.lastname: Harrop
mesh_terms: D002574:Cervical Vertebrae / Q000473:pathology; D002637:Chest Pain / Q000503:physiopathology*; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D055815:Young Adult