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Rheumatology International

, Volume 7, Issue 1, pp 43–46 | Cite as

Atlanto-axial subluxation in patients with seronegative spondylarthritis

  • S. Santavirta
  • P. Slätis
  • J. Sandelin
  • C. Lindqvist
  • Y. T. Konttinen
Case Reports

Summary

Two patients with seronegative HLA-B27-connected spondylarthropathy, associated in one case with psoriasis and in the other with Reiter's disease, who had atlanto-axial subluxation (AAS) are reported. The AAS caused muscle weakness and intractable occipito-cervical pain. Both patients were treated operatively with a Gallie type C1–C2 fusion. The symptoms subsided following surgery and the patients remained free of cervical spine discomfort. The report also indicates that the rarer variants of the HLA-B27 associated chronic seronegative spondylarthropathies may cause AAS complicated by neurological symptoms and that the disorder is amenable to surgical intervention.

Key words

Atlanto-axial subluxation Seronegative spondylarthropathy Psoriasis arthritis Reiter's disease Occipito-cervical pain 

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References

  1. 1.
    Engleman EG, Engleman EP (1977) Ankylosing spondylitis. Recent advances in diagnosis and treatment. Med Clin North Am 61:347–364Google Scholar
  2. 2.
    Kerr R, Resnick D (1985) Radiology of the seronegative spondylarthropathies. Clin Rheum Dis 11:113–146Google Scholar
  3. 3.
    Harris ED Jr (1985) Pathogenesis of rheumatoid arthritis. In: Kelley WN, Harris ED Jr, Ruddy S, Sledge CB (eds) Textbook of rheumatology. Saunders, Philadelphia, pp 993–1007Google Scholar
  4. 4.
    Sokoloff L, Hough AJ Jr (1985) Pathology of rheumatoid arthritis and allied disorders. In: McCarthy DJ (ed) Arthritis and allied conditions. Lea and Febiger, Philadelphia, pp 571–592Google Scholar
  5. 5.
    Bluestone R (1985) Ankylosing spondylitis. In: McCarthy DJ (ed) Arthritis and allied conditions. Lea and Febiger, Philadelphia, pp 819–840Google Scholar
  6. 6.
    Calin A (1985) Ankylosing spondylitis. In: Kelley WN, Harris ED Jr, Ruddy S, Sledge CB (eds) Textbook of rheumatology. Saunders, Philadelphia, pp 886–915Google Scholar
  7. 7.
    Ball J, Sharp J (1971) Rheumatoid arthritis of the cervical spine. In: Hill AGS (ed) Modern trends in rheumatology, vol 2. Appleton-Century-Crofts, New York, pp 117–138Google Scholar
  8. 8.
    Komusi T, Munro T, Harth M (1985) Radiologic review: the rheumatoid cervical spine. Semin Arthritis Rheum 14:187–195Google Scholar
  9. 9.
    Marks JS (1985) Rheumatoid neck. Br J Hosp Med 1:96–100Google Scholar
  10. 10.
    Nakano KK, Schoene WC, Baker RA, Dawason DM (1978) The cervical myelopathy associated with rheumatoid arthritis. Analysis of 32 patients, with 2 postmortem cases. Ann Neurol 3:144–151Google Scholar
  11. 11.
    Reid GP, Hill RH (1978) Atlanto-axial subluxation in juvenile ankylosing spondylitis. J Pediatr 93:531–532Google Scholar
  12. 12.
    Thompson GH, Khan MA, Bilenker RM (1982) Spontaneous atlanto-axial subluxation as presenting manifestation of juvenile ankylosing spondylitis. Spine 7:78–79Google Scholar
  13. 13.
    Resnick D, Niwayama G (1981) Ankylosing spondylitis. In: Resnick D, Niwayama G (eds) Diagnosis in bone and joint disorders. Saunders, Philadelphia, pp 1040–1102Google Scholar
  14. 14.
    Brattström H, Granholm L (1976) Atlanto-axial fusion in rheumatoid arthritis. Acta Orthop Scand 47:619–628Google Scholar
  15. 15.
    Kankaanpää U, Santavirta S (1985) Cervical spine involvement in rheumatoid arthritis. Ann Chir Gynaecol 198:117–121Google Scholar
  16. 16.
    Ranawat CS, O'Leary R, Pellicci P, Tsairis P, Marchisello P, Dorr L (1979) Cervical spine fusion in rheumatoid arthritis. J Bone Joint Surg [Am] 61:1003–1010Google Scholar
  17. 17.
    Kaplan D, Plotz CM, Nathason L, Frank L (1964) Cervical spine in psoriasis and in psoriatic arthritis. Ann Rheum Dis 23:50–56Google Scholar
  18. 18.
    Killebrew D, Gold RM, Sholkoff SD (1973) Psoriatic spondylarthritis. Radiology 108:9–16Google Scholar
  19. 19.
    Latchaw RE, Meyer GW (1978) Reiter disease with atlantoaxial subluxation. Radiology 126:303–304Google Scholar
  20. 20.
    Althoff B, Goldie IF (1980) Cervical collars in rheumatoid atlanto-axial subluxation. Ann Rheum Dis 39:485–489Google Scholar

Copyright information

© Springer-Verlag 1987

Authors and Affiliations

  • S. Santavirta
    • 1
  • P. Slätis
    • 1
  • J. Sandelin
    • 1
  • C. Lindqvist
    • 1
  • Y. T. Konttinen
    • 2
  1. 1.The Division of Orthopaedic Surgery and TraumatologySurgical HospitalHelsinkiFinland
  2. 2.Fourth Department of Medicine, Division of Rheumatic DiseasesUniversity Central HospitalHelsinkiFinland

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