Rheumatoid arthritis - pannus at the craniocervical junction

Case contributed by Abdulmajid Bawazeer
Diagnosis almost certain

Presentation

Known case of rheumatoid arthritis developed progressive severe extremities motor weakness and numbness.

Patient Data

Age: 50 years
Gender: Female

Large soft tissue mass circling odontoid process and posterior aspect of C2 body exerting severe compression upon spinal cord at cervicomedullary junction.
​Fusion of C3-C4 vertebral bodies.

Significant odontoid erosion posteriorly. ​No other bony lesion. ​No basilar invagination.

Case Discussion

Pannus formation is synovial inflammatory mass in association of odontoid erosion has wide differential diagnosis, in our case the patient is known case of rheumatoid arthritis.

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