Cervical spine dynamic instability in patient with rheumatoid arthritis
Rheumatoid arthritis patient planning for intubation. ? cervical spine stability.
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C4-5 and C5-6 anterolistheses which reduce on extension and increase on flexion consistent with significant discoligamentous instability. No obvious median atlantoaxial joint instability demonstrated.
This case emphasizes the importance of assessing for cervical instability in rheumatoid arthritis patients prior to any planned intubation. This patient would have been at significant risk of cord injury if intubation was performed without this knowledge.