Please use this identifier to cite or link to this item: https://hdl.handle.net/11499/10600
Title: A case with rheumatod arthritis and atraumatic odontoid fracture: disappearence of bony landmarks
Authors: Fındıkoğlu, Gülin
Ardic, F.
Akkaya, N.
Sahin, F.
Sabir, N.
Cirak, B.
Keywords: atalantoaxial
axis
fracture
myelopathy
subluxation
vertebra
vertical
adalimumab
corticosteroid
corticotropin
methotrexate
sulfapyridine
antirheumatic agent
adult
anatomic landmark
arm weakness
Article
atlantoaxial dislocation
bone pain
case report
cervical spine
cervical spine dislocation
clinical article
clinical feature
computer assisted tomography
contrast enhancement
decompression surgery
human
laminectomy
limb deformity
male
middle aged
muscle strength
nuclear magnetic resonance imaging
occipital bone
odontoid process fracture
priority journal
radiodiagnosis
rehabilitation care
rheumatoid arthritis
spinal cord disease
spine fusion
complication
diagnostic imaging
injuries
odontoid process
pathophysiology
predictive value
spine fracture
treatment outcome
x-ray computed tomography
Anatomic Landmarks
Antirheumatic Agents
Arthritis, Rheumatoid
Humans
Laminectomy
Magnetic Resonance Imaging
Male
Middle Aged
Odontoid Process
Predictive Value of Tests
Spinal Fractures
Spinal Fusion
Tomography, X-Ray Computed
Treatment Outcome
Publisher: Blackwell Publishing
Abstract: We aim to draw attention to occult, atraumatic fractures of the odontoid process in patients with rheumatoid arthritis (RA) and to underline difficulties encountered during clinical and radiological diagnosis. A forty-seven years old man with RA for 4 years had occipital pain for 1 year without any history of trauma. Later, he developed weakness in the upper extremities, but he did not realize weakness in the lower extremities due to deformities. Contrast magnetic resonance imaging revealed a linear fracture of odontiod process and myelopathy. Cervical computed tomography scan revealed an old fracture border with separated and almost disappeared remnant of the tip of the odontoid without free particles in the cord. It was impossible to evaluate atlantoaxial and vertical subluxations with craniometric measurements due to destruction of the tip of odontoid. Following occipitocervical fusion and decompression and a rehabilitation program, his muscle strength improved; however, functional myelopathy stage did not change. Atraumatic fractures of the odontoid process may be more common than reported and may cause compression of the spinal cord or brain stem. Surgery is the treatment of choice but functional recovery is limited once neuronal damage has occurred. Erosion of the critical landmarks makes it difficult to diagnose and follow up atlantoaxial subluxation and/or vertical subluxation, therefore clinicians should consider radiographical follow-ups during the course of the disease. © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd
URI: https://hdl.handle.net/11499/10600
https://doi.org/10.1111/1756-185X.12455
ISSN: 1756-1841
Appears in Collections:PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection
Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection
Tıp Fakültesi Koleksiyonu
WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection

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