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Computerized tomography in persons with Down syndrome and atlantoaxial instability
S M Pueschel1, A C Moon, F H Scola
1Department of Pediatrics, Rhode Island Hospital, Brown University Program in Medicine, Providence.
Spine
|July 1, 1992
Summary
Atlantoaxial instability is common in Down syndrome. Computerized tomography better detects C1-C2 skeletal anomalies and spinal cord compression than standard X-rays, revealing discrepancies in measurements.
Area of Science:
- Orthopedics
- Radiology
- Genetics
Background:
- Atlantoaxial instability (AAI) affects 9-31% of individuals with Down syndrome.
- AAI can lead to serious neurological complications.
Purpose of the Study:
- To compare the diagnostic utility of routine roentgenograms and computerized tomography (CT) in evaluating the atlantoaxial region in patients with Down syndrome.
- To identify skeletal anomalies and spinal cord compression not visible on plain X-rays.
Main Methods:
- Retrospective analysis of a subsample of patients with Down syndrome.
- Comparison of imaging data from routine roentgenograms and CT scans of the C1-C2 region.
Main Results:
- CT revealed numerous skeletal anomalies in the C1-C2 region and spinal cord compression missed by plain roentgenograms.
- Measurements of the atlanto-dens interval were significantly larger on plain roentgenograms compared to CT, due to magnification.
Conclusions:
- CT is superior to routine roentgenograms for detecting atlantoaxial abnormalities in Down syndrome.
- Standard X-rays may overestimate atlanto-dens interval, potentially leading to misdiagnosis or unnecessary interventions.