Lewandrowski Kai-Uwe, Park Paul P, Baron Jeffrey M, Curtin Stephen L
Center for Advanced Spinal Surgery, Southwest Orthopaedic Surgery Specialists, PLC, 3395 N Campbell Avenue, Tucson, AZ 85719, USA.
Spine J. 2006 Sep-Oct;6(5):529-33. doi: 10.1016/j.spinee.2005.09.012.
Instability of the cervical spine is a common problem in patients with rheumatoid arthritis. The natural course of rheumatoid arthritis in the cervical spine is well documented. However, the true prevalence of occult fractures of the odontoid process in patients with rheumatoid arthritis is not known.
To draw attention to the possibility of occult, atraumatic fractures of the odontoid process in patients with rheumatoid arthritis.
We report on two cases with previously unrecognized fractures of the odontoid process.
In this case series, we review the individual radiographic findings and clinical observations in two rheumatoid patients in whom a fracture of the odontoid process was diagnosed.
Each one of these two rheumatoid patients had an unrecognized fracture of the odontoid process without any prior history of trauma. Their fracture was identified serendipitously during workup for neck pain.
Occult, atraumatic fractures of the odontoid process may be found in patients with long-standing rheumatoid arthritis. This injury should be suspected if previously asymptomatic patients complain about new onset of neck pain without significant trauma.
颈椎不稳是类风湿关节炎患者的常见问题。类风湿关节炎在颈椎的自然病程已有充分记录。然而，类风湿关节炎患者齿状突隐匿性骨折的真实患病率尚不清楚。
提醒人们注意类风湿关节炎患者发生齿状突隐匿性、非创伤性骨折的可能性。
我们报告两例此前未被识别的齿状突骨折病例。
在这个病例系列中，我们回顾了两名被诊断为齿状突骨折的类风湿患者的个体影像学表现和临床观察结果。
这两名类风湿患者均有未被识别的齿状突骨折，且均无任何既往创伤史。他们的骨折是在因颈部疼痛进行检查时偶然发现的。
长期类风湿关节炎患者可能存在齿状突隐匿性、非创伤性骨折。如果既往无症状的患者在无明显创伤的情况下出现新发颈部疼痛，应怀疑有这种损伤。
