Nontraumatic Cervical Dislocations in Rheumatoid Spondylitis

Although the occurrence of dislocations in peripheral joints affected with rheumatoid arthritis is well known, the fact that cervical spine subluxations may likewise complicate rheumatoid spondylitis has not been generally realized. Similarly, rheumatoid spondylitis has received only scant mention in the literature as a cause of spontaneous atlantoaxial dislocations, which have been repeatedly ascribed to cervical or nasopharyngeal inflammations in childhood, rheumatic fever, and tuberculosis of the spine. Ely1has reported atlantoaxial subluxation that occurred in a patient with rheumatoid arthritis. His patient, however, had a history of injury that may have precipitated the dislocation. More recently Stammers and Frazer2reported spontaneous subluxation of the atlas in a 30-year-old man who had a five year history suggestive of rheumatoid spondylitis, although this diagnosis was not mentioned. Rand3described a case of progressive subluxation of the atlas that caused a classic Brown-Sequard syndrome that was relieved by strong