Upward Translocation of the Dens in Rheumatoid Arthritis

A diagnosis of upward translocation of the dens was made in eight patients with chronic rheumatoid arthritis selected from a group of patients who had radiographic studies of the cervical spine and from whom a number of patients with atlanto-axial subluxation were also identified. 2. Two of the patients presented with an acute neurological syndrome of serious import and required a stabilisation operation. Though this is an uncommon complication of rheumatoid arthritis it seems that urgent neurological syndromes are likely to be more common than in atlanto-axial subluxation.