Article

Patients with spondyloarthritis (SpA) typically present with inflammatory back
pain, peripheral arthritis and enthesitis, often with distinctive clinical
features such as psoriasis and inflammatory bowel diseases. Atlanto-axial
subluxation (AAS) is a complication occurring rarely in these patients, and
usually is seen in patients with longstanding, severe disease. We present three
cases of AAS whose initial presentation of AAS was followed by subsequent
development of signs and symptoms meeting the European Spondyloarthropathy Study
Group (ESSG) classification criteria for SpA. All three patients were less than
30 years of age and had no other explanation for the AAS. Significantly, all
three patients required C1/C2 surgical fusion within 1 year of symptom onset due
to severe pain, though none of them developed neurologic complications related to
AAS such as myelopathy. Peripheral arthritis/tendonitis, the presence of HLA-B27
gene and family history of SpA appeared to be associated with higher risk of
evolution to SpA in these patients. No medical therapy has been systematically
examined in this condition.
CI - Copyright (c) 2011 Societe francaise de rhumatologie. Published by Elsevier SAS.
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Langue : ANGLAIS