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Odontoid fracture and C1-C2 subluxation in psoriatic cervical spondyloarthropathy. A case report
1Department of Physical Medicine, St. Vincent's Hospital and Medical Center of New York, USA.
Study Design:
Case presentation and review of pertinent literature.
Objectives:
To present an unusual case and alert other physicians to possible missed diagnoses.
Summary Of Background Data:
An unusual case is presented of a young man with server psoriatic spondyloarthropathy and fusion of C2-C7 (Type II cervical psoriatic ankylosing disease) who fell at home, sustaining an unrecognized fracture of the odontoid process leading to subluxation of C1-C2 and the transitory tetraplegia. The patient presented with torticollis, and the fracture was unrecognized for a long period of time.
Methods:
Case presentation.
Results:
This patient became independent in all activities of daily living after surgery and rehabilitation despite persistence of torticollis.
Conclusions:
A patient who presents clinically with traumatic torticollis after minor trauma and who also has psoriasis and ankylosis of the cervical spine should be suspected of having a fracture-subluxation until definitely proven otherwise. In the present case, the late diagnosis delayed surgical stabilization.
