Atloido-Axoid Dislocation in Rheumatoid Arthritis

Rheumatoid arthritis (RA) is the most common inflammatory rheumatism, with a prevalence of up to one percent worldwide. Indeed, the classical presentation of the disease is generally a bilateral and symmetrical polyarticular involvement affecting small joints of the hand as well as the forefoot. Spinal involvement could be observed in RA, particularly after an average of 10 years of disease duration. It is a common event with a prevalence of 14–88%. This involvement is the third most frequent after that of hands and feet; however it is a very unusual form of RA presentation. Atlantoaxial subluxations dominates damage of the upper cervical spine, mainly related to the C1–C2 pannus and the rupture of the transverse ligament. Silent forms are common, but the clinical resentation is very polymorphic and can range from neck pain neglected by the patient to spinal cord compression.