Diagnosis of Atlantoaxial Instability Requires Clinical Suspicion to Drive the Radiological InvestigationFraser C Henderson Sr.1,2* and Fraser C Henderson Jr.3
- *Corresponding Author:
- Fraser Cummins Henderson Sr.
M.D., 8401 Connecticut Avenue
Suite 220, Chevy Chase, MD 20815, USA
Fax: 301- 654-9394
E-mail: [email protected]
Received Date: March 25, 2017 Accepted Date: March 30, 2017 Published Date: April 01, 2017
Citation: Henderson Sr. FC, Henderson Jr. FC (2017) Diagnosis of Atlantoaxial Instability Requires Clinical Suspicion to Drive the Radiological Investigation. J Spine 6: 364. doi: 10.4172/2165-7939.1000364
Copyright: © 2017 Henderson Sr. FC, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Atlantoaxial instability (AAI) occurs as a result of trauma, congenital conditions such as os odontoideum, neoplasm, infection and degenerative connective tissue disorders such as rheumatoid arthritis, genetic conditions such as HOX-D3 and Down syndrome, and heritable connective tissue disorders, emblematic of which are the Ehlers Danlos syndromes (EDS). Prototypical of disorders in which AAI is diagnosed, is rheumatoid arthritis (RA). Prior to the development of effective disease-modifying pharmacotherapies, 88% of RA patients exhibited radiographic evidence of C1-C2 involvement, in whom 49% were symptomatic and 20% myelopathic; ultimately, 10% may have suffered atlantoaxial dislocation and death.