Atlanto-axial dislocation in rheumatoid arthritis--diagnostic and therapeutic aspects

Symptoms, signs and neuroradiological findings of 15 cases with atlanto-axial dislocation (AAD) due to rheumatoid arthritis are presented. CT of the craniocervical region revealed the exact anatomical relationships between the dens, the subarachnoid space and the brain stem, especially after intrathecal contrast medium injection and different positions of the head. From the results of operative procedures to reduce AAD it was concluded that early diagnosis and treatment of AAD leads to prompt relief of painful symptoms within 3 months and protects from neurological deterioration.