Syringomyelia associated to rheumatoid-atlantoaxial subluxation: about a new case
Dhia Kaffel, Wafa Hamdi
Corresponding author: Dhia Kaffel, Rheumatology Department, Kassab Institute, Manouba, Tunisia 
Received: 19 Jul 2017 - Accepted: 06 Oct 2017 - Published: 19 Oct 2017
Domain: Rheumatology,Neurology (general)
Keywords: Syringomyelia, atlantoaxial subluxation, rheumatoid arthritis
©Dhia Kaffel et al. Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cite this article: Dhia Kaffel et al. Syringomyelia associated to rheumatoid-atlantoaxial subluxation: about a new case. Pan African Medical Journal. 2017;28:158. [doi: 10.11604/pamj.2017.28.158.13403]
Available online at: https://www.panafrican-med-journal.com/content/article/28/158/full
Original article 
Syringomyelia associated to rheumatoid-atlantoaxial subluxation: about a new case
Syringomyelia associated to rheumatoid-atlantoaxial subluxation: about a new case
Dhia Kaffel1,&, Wafa Hamdi1
1Rheumatology Department, Kassab Institute, Manouba, Tunisia
&Corresponding author
Dhia Kaffel, Rheumatology Department, Kassab Institute, Manouba, Tunisia
We report a case of 64-year-old Tunisian woman with a 12-year history of rheumatoid arthritis, who presented with a 3-month history of increasing inflammatory neck pain. Neurological examination noted a quadripyramidal syndrome without any neurological deficit. Radiographs of her neck showed ananterior atlantoaxial subluxation (A). MRI revealed a pannus around the atlanto axial joint. It also showed a co-existing syringomyelia (B). The cervical spine is frequently involved in patients with rheumatoid arthritis. However, rheumatoid atlantoaxial subluxation with syringomyelia is very rare. Many hypothesised mechanisms were suggested for the syrinx formation. The most commonly admitted, suggested that atlanto axial subluxation may reduce the rate of ascending cerebrospinal fluid, so it would travel through the spinal cord producing syringomyelia.
Figure 1: (A) radiograph of a cervical spine showing ananterior atlantoaxial subluxation; (B) MRI showing a pannus around the atlantoaxial joint with a co-existing syringomyelia
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