We report a case of 64-year-old Tunisian woman with a 12-year history of rheumatoid arthritis, who presented with a 3-month history of increasing inflammatory neck pain. Neurological examination noted a quadripyramidal syndrome without any neurological deficit. Radiographs of her neck showed ananterior atlantoaxial subluxation (A). MRI revealed a pannus around the atlanto axial joint. It also s...

Cervical spine is involved in a significant proportion of patients suffering from rheumatoid arthritis. Although cervical spine disease may often be 'benign', neurological complications are not uncommon. Patients of rheumatoid arthritis should be screened for cervical spine involvement and appropriately treated with combination of anti-rheumatic drugs. We report a case of quadriparesis secondar...

Radiological abnormalities in the cervical spine were assessed in detail in a group of 62 patients with rheumatoid arthritis of approximately 15 years' duration, of whom 33 had been treated with corticosteroids and 29 had not. The 10 criteria of damage described by Bland (1974), which include subluxation, correlated as a whole with the severity of the disease in general but not with the duratio...

Background: Atlantoaxial subluxation occurs when there is misalignment of the atlantoaxial joint. Several etiologies confer increased risk in children, including neck trauma, inflammation, infection, or inherent ligamentous laxity cervical spine.
 Methods: A case study was performed. Demographics and clinical data were reviewed for etiology, imaging techniques, treatment, clinic outcomes.&...

Grisel syndrome is a condition of uncertain etiology characterized by a non-traumatic atlantoaxial subluxation following an infection in the head and neck region. Although first described in 1830, the exact pathophysiology of Grisel syndrome remains unclear. We present a case of atlantoaxial subluxation after acute lymphadenitis diagnosed with a dynamic computed tomography (CT) and magnetic res...

ATLANTOAXIAL subluxation (AAS) is found in 11– 46% of patients with rheumatoid arthritis. Rheumatoid patients with AAS may be at risk of life-threatening neurologic injury caused by exacerbation of the subluxation in the head and neck position during airway maneuver; therefore, appropriate management of the cervical spine is essential. Tokunaga et al. have recommended the protrusion position, w...

Cervical joint disease in rheumatoid arthritis patients is common. These patients may be at risk for severe life-threatening neurological problems in the perioperative period and thus present a challenge to the anaesthetist. By understanding the various anatomical abnormalities that may occur in rheumatoid cervical joint disease, the anaesthetist can design an appropriate management plan for th...

Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disorder affecting multiple organ systems, joints, ligaments, and bones and commonly involves the cervical spine. Chronic synovitis may result in bony erosion and ligamentous laxity that result in instability and subluxation. Anterior atlantoaxial subluxation (AAS) is the most frequently occurring deformity, due to laxity of the prim...

BACKGROUND Disorders of the cervical spine are often observed in patients with rheumatoid arthritis (RA). However, the best head position for RA patients with atlantoaxial subluxation in the perioperative period is unknown. This study investigated head position during general anesthesia for the patients with RA and proven atlantoaxial subluxation. METHODS During anesthesia of patients with RA...

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