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Inflammatory C2-3 subluxation: a Grisel's syndrome variant
J F Martínez-Lage1, T Morales, V Fernandez Cornejo
1Virgen de la Arrixaca University Hospital, Unit of Paediatric Neurosurgery, El Palmar, Murcia, Spain. jfmlage@arrixaca.huva.es
Archives of Disease in Childhood
|June 24, 2003
Summary
Grisel's syndrome, typically affecting the atlanto-axial joint, can also manifest at the C2-3 segment. This case report details a pediatric patient successfully treated for this rare presentation of non-traumatic neck subluxation.
Area of Science:
- Pediatric Orthopedics
- Rheumatology
- Infectious Diseases
Background:
- Grisel's syndrome involves non-traumatic atlanto-axial subluxation with adjacent neck inflammation.
- It is often associated with upper respiratory tract infections.
Observation:
- A 5-year-old boy presented with recurrent head tilt and painful neck movements following sinusitis.
- Radiographic imaging revealed subluxation specifically at the C2-3 cervical joint.
Findings:
- This case represents a rare, symptomatic presentation of Grisel's syndrome at the C2-3 segment, distinct from the classic atlanto-axial location.
- Conservative management including a cervical collar, physiotherapy, and NSAIDs resulted in a complete recovery.
Implications:
- Grisel's syndrome may occur at cervical levels beyond the typical atlanto-axial joint.
- Highlights the importance of considering Grisel's syndrome in pediatric patients with neck pain and restricted movement post-infection, even with atypical radiographic findings.