Atypical Presentation of Behcet's Disease with Atlanto Axial Joint Pain as Initial Presentation-A Case Report

Behcet's disease (BD) is a chronic and multi-systemic disorder with inflammatory characteristics. It is manifested by recurrent oral aphthae, skin lesions, ocular disease, gastrointestinal involvement, neurological disorders, and vascular disease. Arthritis is seen in half of the patients. However, it rarely affects the spinal column, and patients presenting with neck pain have been reported only in one case in the literature.

Here we report a case of 39 year old male patient with BD whose primary symptom was neck pain. Anti-tubercular therapy was started empirically suspecting cervical tuberculosis. He was further evaluated as he was also developing skin and oral lesions. He was diagnosed to be having Behcet's disease and was started on colchicine, with which both his skin lesions and neck pain improved symptomatically.

This case emphasizes that despite atlanto-axial joint pain is a rare manifestation of BD, clinicians should suspect it a differential diagnosis in patients with neck joint pain along with mucous or cutaneous lesions. Accurate diagnosis and early management have to be done to prevent further joint dislocation and associated fatalities.