Atlantoaxial Subluxation in Undifferentiated Spondyloarthropathy: A case report.

, Rhee, Won Ihl; , Jeung, In Suek; , Heo, Nam Yeon; , Han, Zee A; , Mok, Sung Kyun

Case Report

Journal of the Korean Academy of Rehabilitation Medicine 2008;32(3):361-365.

Rhee, Won Ihl , Jeung, In Suek , Heo, Nam Yeon , Han, Zee A , Mok, Sung Kyun

Department of Rehabilitation Medicine, College of Medicine, The Catholic University of Korea, Korea. dejavu1020@empas.com

환추축 아탈구를 동반한 미분화 척추관절증-증례 보고-

이원일, 정인숙, 허남연, 한지아, 목성균

가톨릭대학교 의과대학 재활의학교실

Abstract

Atlantoaxial subluxation in undifferentiated spondyloarthropathy is extremely rare and has not been reported. We describe a case of 27-year-old man who was diagnosed as undifferentiated spondyloarthropathy with atlantoaxial subluxation with an initial complaint of painful swelling of right 1st metatarsophalangeal joint and posterior neck pain. Roentgenograms showed sclerotic change and increased hazziness in right 1st metatarsophalangeal joint. Magnetic resonance images and roentgenograms of the cervical spine showed inflammation of odontoid process and atlantoaxial subluxation. Bone scan showed hot uptakes in left sacroiliac joint, right 1st & 4th metacarpophalangeal joints and 1st metatarsophalangeal joint. HLA-B27 gene was positive. Spontaneous atlantoaxial subluxation and undifferentiated spondyloarthropathy was diagnosed and conservatively treated with oral medication. Currently, there is no definite neurological sign. Early recognition and awareness of potential clinical complications is important in preventing compressive damage on central nervous system. (J Korean Acad Rehab Med 2008; 32: 361-365)

Key Words: Seronegative spondyloarthropathy, Undifferentiated spondyloarthropathy, Atlantoaxial subluxation