Grisel's Syndrome Induced by Mycobacterium tuberculosis

Area of Science:

• Medical Case Report
• Infectious Disease
• Orthopedic Surgery

Background:

• Grisel's syndrome involves non-traumatic atlantoaxial joint subluxation due to upper neck inflammation.
• Identifying the specific pathogen in Grisel's syndrome lesions is uncommon in medical literature.

Purpose of the Study:

• To report the first case in Korea of Grisel's syndrome secondary to a retropharyngeal abscess caused by pulmonary tuberculosis.
• To illustrate the successful management and outcomes of this rare condition.

Main Methods:

• A 36-year-old female patient diagnosed with Grisel's syndrome.
• Treatment involved an anti-tuberculosis regimen and Philadelphia collar immobilization.
• Magnetic resonance imaging (MRI) and dynamic cervical radiography were used for diagnosis and follow-up.

Main Results:

• The patient presented with atlantoaxial subluxation secondary to a retropharyngeal abscess from pulmonary tuberculosis.
• Treatment with medication and immobilization led to improved atlantoaxial alignment on MRI.
• The patient remained neurologically intact with stable atlantoaxial joints upon follow-up.

Conclusions:

• This case highlights pulmonary tuberculosis as a rare cause of Grisel's syndrome.
• Effective management involves addressing the underlying infection and stabilizing the cervical spine.
• Early diagnosis and treatment can lead to favorable outcomes in Grisel's syndrome.