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Related Experiment Video

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Assessing Forelimb Function after Unilateral Cervical SCI using Novel Tasks: Limb Step-alternation, Postural Instability and Pasta Handling

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Odontoid cervical gout causing atlantoaxial instability: case report.

Justin Slavin¹, Marcello DiStasio², Paul F Dellaripa³

¹Departments of1Neurosurgery and.

Journal of Neurosurgery. Spine

|January 27, 2019

Summary

Gout caused a rare C1-2 joint rotatory subluxation and retroodontoid pannus. Surgical fusion and biopsy confirmed gout, avoiding further procedures for this complex atlantoaxial instability case.

Keywords:

cervical spine gout odontoid

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Area of Science:

Rheumatology
Orthopedic Surgery
Diagnostic Imaging

Background:

A patient with a history of gout, sarcoidosis, and possible rheumatoid arthritis presented with symptoms of atlantoaxial instability.
The diagnostic challenge was compounded by the patient's demographic and the need to rule out oncological processes.

Observation:

The patient exhibited rotatory subluxation of the C1-2 joint and a large retroodontoid pannus with an enhancing lesion in the odontoid process.
Despite the pannus, there was no evidence of spinal cord compression on clinical examination or imaging.

Findings:

Posterior stabilization was performed to address the C1-2 instability and rotatory subluxation.
A posterior biopsy of the retroodontoid pannus confirmed gout as the underlying cause, avoiding the need for anterior decompression.

Implications:

This case highlights the importance of considering gout in the differential diagnosis of atlantoaxial instability, even with co-existing inflammatory conditions.
A combined surgical and diagnostic approach can confirm rare etiologies while minimizing patient morbidity.