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Case Reports1 August 1951RHEUMATOID ARTHRITIS WITH DEATH FROM MEDULLARY COMPRESSIONF. W. DAVIS JR., M.D., H. E. MARKLEY, M.D.F. W. DAVIS JR., M.D.Search for more papers by this author, H. E. MARKLEY, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-35-2-451 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptDeath as a direct complication of rheumatoid arthritis is a distinctly uncommon occurrence, despite the frequency and generalized nature of the disease. Over a 25 year period at the Mayo Clinic, 30 necropsies were performed on cases of rheumatoid arthritis and among these there were no neurologic deaths.1 We have recently had the opportunity of observing a case in which demise was felt to have resulted from compression of the medulla oblongata by the odontoid process. The herniation of this process was secondary to destructive osseous changes of rheumatoid arthritis.CASE REPORTA 58 year old physician's wife was admitted...Bibliography1. RosenbergBaggenstossHench DHAHPS: Causes of death in thirty cases of rheumatoid arthritis, Ann. Int. Med. 20: 903-919, 1944. LinkGoogle Scholar2. Bézi I: Assimilation of the atlas and compression of medulla, Arch. Path. 12: 333-357, 1931. Google Scholar3. BerkheiserSeidler EJF: Nontraumatic dislocations of the atlanto-axial joint, J. A. M. A. 96: 517-523, 1931. CrossrefGoogle Scholar4. LittlePascucci SCLM: Basilar impression and associated deformities, New York State J. Med. 45: 638-642, 1945. Google Scholar5. Hadley LA: Platybasia and occipital vertebra causing foramen magnum encroachment and resulting neurological symptoms, New York State J. Med. 44: 2355-2357, 1944. Google Scholar6. Saunders WW: Basilar impression: the position of the normal odontoid, Radiology 41: 589-590, 1943. CrossrefGoogle Scholar7. Moorhead JJ: Clinical traumatic surgery, 1945, W. B. Saunders Co., Philadelphia, p. 410. Google Scholar8. Englander O: Non-traumatic occipito-atlanto-axial dislocation, Brit. J. Radiol. 15: 341-345, 1942. CrossrefGoogle Scholar9. Evans WA: Pathological dislocations at the atlanto-axial joint: an unusual complication of rheumatic fever, Radiology 37: 347-350, 1941. CrossrefGoogle Scholar10. HessBronsteinAbelson JHIPSM: Atlanto-axial dislocations unassociated with trauma and secondary to inflammatory foci in the neck, Am. J. Dis. Child. 49: 1137-1147, 1935. CrossrefGoogle Scholar11. Whalley N: Paget's disease of atlas and axis, J. Neurol., Neurosurg. and Psychiat. 9: 84-86, 1946. CrossrefGoogle Scholar12. Lawrence HF: A case of compression of the medulla and upper segment of the spinal cord by osteitis of the atlas and axis, U. S. Nav. M. Bull. 28: 783-787, 1930. Google Scholar13. Grinker RR: Neurology, 1943, Chas. C. Thomas, Springfield, Illinois, p. 216. Google Scholar14. StammersFrazer FAP: Spontaneous dislocation of the atlas, Lancet 2: 1203-1205, 1933. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: *Received for publication June 7, 1949.From the Medical Clinic, The Johns Hopkins Hospital, Baltimore, Maryland. 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ROBINSON, M.D., F.A.C.P., JOSEPH J. BUNIM, M.D., F.A.C.P., WILLIAM S. CLARK, M.D., DARRELL C. CRAIN, M.D., F.A.C.P., EPHRAIM P. ENGLEMAN, M.D., F.A.C.P., DONALD C. GRAHAM, M.D., F.R.C.P. (C), MAX M. MONTGOMERY, M.D., F.A.C.P., BERNARD M. NORCROSS, M.D., F.A.C.P., CHARLES RAGAN, M.D., F.A.C.P., MARIAN W. ROPES, M.D., F.A.C.P., EDWARD F. ROSENBERG, M.D., F.A.C.P., CHARLEY J. SMYTH, M.D., F.A.C.P. 1 August 1951Volume 35, Issue 2Page: 451-454KeywordsHospitalsRheumatoid arthritis ePublished: 1 December 2008 Issue Published: 1 August 1951 PDF downloadLoading ...
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