Acute neck pain caused by arthritis of the lateral atlantoaxial joint

Kobayashi, Takashi; Miyakoshi, Naohisa; Konno, Naoaki; Abe, Eiji; Ishikawa, Yoshinori; Shimada, Yasuhiro

doi:10.1016/j.spinee.2013.10.054

Cited by 15 publications

(17 citation statements)

References 12 publications

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“…Acute neck pain is often caused by crystal-induced arthritis of the lateral atlantoaxial joint [ 1 ] or CDS [ 29 ] in the elderly. Vertebral osteomyelitis of the upper cervical spine is very important in the differential diagnosis of crystal-induced arthritis, because early diagnosis is needed for an optimal outcome of vertebral osteomyelitis.…”

Section: Discussionmentioning

confidence: 99%

“…If severe neck pain continues, osteomyelitis of the cervical region should be considered in the differential diagnosis. On CT, bone destruction was seen in the present patient with septic arthritis, while calcification around the dens is seen in most cases of crystal-induced arthritis of the lateral atlantoaxial joint [ 1 ]. MRI is the preferred imaging method because of the excellent soft tissue contrast that is achievable.…”

Section: Discussionmentioning

confidence: 99%

“…MRI is the preferred imaging method because of the excellent soft tissue contrast that is achievable. A lateral atlantoaxial joint effusion was visible in the present patient with septic arthritis, but soft tissue swelling or joint effusion is not seen in crystal-induced arthritis of the lateral atlantoaxial joint (Table 1 ) [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

“…Crystal-induced arthritis of the lateral atlantoaxial joint may be intimately involved in acute neck pain in the elderly [ 1 ]. Patients typically have a good prognosis, and symptoms usually subside within a few weeks.…”

Section: Introductionmentioning

confidence: 99%

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Acute neck pain caused by septic arthritis of the lateral atlantoaxial joint with subluxation: a case report

et al. 2015

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IntroductionCrystal-induced arthritis of the lateral atlantoaxial joint may be intimately involved in acute neck pain in the elderly. Patients typically have a good prognosis, and symptoms usually subside within a few weeks. On the other hand, septic arthritis of the lateral atlantoaxial joint requires early diagnosis and antibiotic treatment. Diagnostic delay is a risk factor for an unfavorable outcome of vertebral osteomyelitis. Even though septic arthritis of the lateral atlantoaxial joint is a very rare clinical entity, it is important to differentiate septic arthritis from crystal-induced arthritis.Case presentationA 53-year-old Japanese man presented with neck pain, stiffness, and loss of power of his left upper extremity which started 20 days before his visit to our hospital. A physical examination revealed a limited range of motion of his neck, with rotation being especially very restricted. Atlantoaxial subluxation was seen on plain radiography of his cervical spine. During puncture of the lateral atlantoaxial joint, clear yellow fluid was collected. Cultures later grew methicillin-sensitive Staphylococcus aureus. He was diagnosed with septic arthritis of the lateral atlantoaxial joint with atlantoaxial subluxation. After diagnosis, intravenous administration of antibiotics was begun. The atlantoaxial region was stabilized with the Brooks procedure. Plain radiography showed complete bone union 8 months after operation. At a follow-up evaluation 7 years after initial onset, he had complete relief of neck pain, and there were no neurological abnormalities.ConclusionsA patient with septic arthritis of the lateral atlantoaxial joint with subluxation presenting with acute neck pain was successfully treated with antibiotics and fusion surgery. In patients with persistent neck pain, septic arthritis of the lateral atlantoaxial joint should be considered and further examinations performed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Acute neck pain caused by septic arthritis of the lateral atlantoaxial joint with subluxation: a case report

et al. 2015

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“…Table 1 provides information on the diagnostic modalities and EULAR evidence levels. Two studies examined CR, 6 7 12 studies examined U/S, [8][9][10][11][12][13][14][15][16][17][18][19] 1 study examined CT, 20 1 study examined DECT, 21 3 studies examined CCA, 22-24 4 studies examined Raman spectroscopy, 25-28 1 study examined elemental bioanalysis 29 and 2 studies examined metabolomic or other mass spectrometry. 30 31 Quality assessment Overall, the included studies met most of the quality indicators of the QUADAS-2 tool (figure 2).…”

Section: Study Identificationmentioning

confidence: 99%

Systematic review and quality analysis of emerging diagnostic measures for calcium pyrophosphate crystal deposition disease

Wu¹,

K²,

Terkeltaub³

2016

RMD Open

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ObjectivesCalcium pyrophosphate crystal deposition disease (CPPD) is common, yet prevalence and overall clinical impact remain unclear. Sensitivity and specificity of CPPD reference standards (conventional crystal analysis (CCA) and radiography (CR)) were meta-analysed by EULAR (published 2011). Since then, new diagnostic modalities are emerging. Hence, we updated 2009–2016 literature findings by systematic review and evidence grading, and assessed unmet needs.MethodsWe performed systematic search of full papers (PubMed, Scopus/EMBASE, Cochrane 2009–2016 databases). Search terms included CPPD, chondrocalcinosis, pseudogout, ultrasound, MRI, dual energy CT (DECT). Paper selection, data abstraction, EULAR evidence level, and Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 bias and applicability grading were performed independently by 3 authors.ResultsWe included 26 of 111 eligible papers, which showed emergence in CPPD diagnosis of ultrasound (U/S), and to lesser degree, DECT and Raman spectroscopy. U/S detected CPPD crystals in peripheral joints with sensitivity >80%, superior to CR. However, most study designs, though analytical, yielded low EULAR evidence level. DECT was marginally explored for CPPD, compared with 35 published DECT studies in gout. QUADAS-2 grading indicated strong applicability of U/S, DECT and Raman spectroscopy, but high study bias risk (in ∼30% of papers) due to non-controlled designs, and non-randomised subject selection.ConclusionsThough CCA and CR remain reference standards for CPPD diagnosis, U/S, DECT and Raman spectroscopy are emerging U/S sensitivity appears to be superior to CR. We identified major unmet needs, including for randomised, blinded, controlled studies of CPPD diagnostic performance and rigorous analyses of 4 T MRI and other emerging modalities.

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