Atlanto-axial subluxation

Case contributed by Dr Henry Knipe

Presentation

Fall. Painful neck on passive movement.

Patient Data

Age: 67
Gender: Female
Modality: CT

Atlanto-axial rotatory subluxation with 10 mm posterior displacement of C1 on C2 the left and widening of the left C1/2 facet joint. Remainder of the facet joints are enlocated and there is no other malalignment of the cervical spine. No acute fracture is identified.

Degenerative change at the atlantoaxial articulation with loss of joint space at the atlanto-dens articulation and soft tissue calcification; consideration should be given to depositional disease (e.g. CPPD) or an autoimmune process (less likely as erosions are not a predominant feature) causes.

Right posterior fossa craniectomy and plate reconstruction.

Conclusion:

Atlanto-axial subluxation. No acute fracture.

Case Discussion

Atlanto-axial subluxation may be congenital or secondary to arthritides (e.g. rheumatoid arthritis) or trauma. 

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Case Information

rID: 36610
Case created: 1st May 2015
Last edited: 8th Feb 2016
Inclusion in quiz mode: Included

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