Atraumatic odontoid fractures in patients with rheumatoid arthritis

Kai-Uwe Lewandrowski, Paul P. Park, Jeffrey M. Baron and Stephen L. Curtin

The purpose of this study was to draw attention to the possibility of occult, atraumatic fractures of the odontoid process in patients with rheumatoid arthritis.  Instability of the cervical spine is a common problem in patients with rheumatoid arthritis. The natural course of rheumatoid arthritis in the cervical spine is well documented. However, the true prevalence of occult fractures of the odontoid process in patients with rheumatoid arthritis is not known.  This article reports on two cases with previously unrecognized fractures of the odontoid process.  The conclusion is that occult, atraumatic fractures of the odontoid process may be found in patients with long-standing rheumatoid arthritis. This injury should be suspected if previously asymptomatic patients complain about new onset of neck pain without significant trauma.

The Spine Journal, Volume 6, Issue 5, September-October 2006, Pages 529-533

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