Slouma Maroua, Dghaies Abir, Dhahri Rim, Bouzid Sirine, Battikh Riadh, Gharsallah Imen, Metoui Leila, Louzir Bassem
Department of Internal Medicine Military Hospital Tunis El Manar University - Tunisia Tunis Tunisia.
Clin Case Rep. 2022 Apr 4;10(4):e05695. doi: 10.1002/ccr3.5695. eCollection 2022 Apr.
Pyogenic arthritis of the atlantoaxial joint is scarce. It can lead to several complications, such as spinal cord compression and cerebral vein thrombosis. A 51-year-old man presented with a twenty-day history of inflammatory neck pain. Physical examination revealed paravertebral muscle contracture, restricted neck movement, and fever. Spine magnetic resonance imaging (MRI) showed synovitis of atlanto-odontoid joint, anterior epidural collection, and cerebral vein thrombosis. Transthoracic echocardiography was unremarkable. The patient was successfully treated with anti-staphylococcal antibiotic treatment for 12 weeks associated with immobilization of the cervical spine. MRI performed one month after the initiation of the treatment showed disappearance of the epidural collection. The diagnosis of septic arthritis of the atlantoaxial joint should be considered in a patient with inflammatory neck pain. MRI findings are relevant in making the diagnosis of a septic atlanto-odontoid joint. Conservative treatment, including antibiotic and neck immobilization, can be sufficient for the treatment of pyogenic arthritis of the atlantoaxial joint. Cerebral vein thrombosis is a rare complication due to septic arthritis of the atlantoaxial joint.
寰枢关节化脓性关节炎较为罕见。它可导致多种并发症,如脊髓受压和脑静脉血栓形成。一名51岁男性,有20天的炎性颈部疼痛病史。体格检查发现椎旁肌肉挛缩、颈部活动受限和发热。脊柱磁共振成像(MRI)显示寰齿关节滑膜炎、硬膜外积液和脑静脉血栓形成。经胸超声心动图检查无异常。该患者接受了12周的抗葡萄球菌抗生素治疗,并结合颈椎固定,治疗成功。治疗开始1个月后进行的MRI显示硬膜外积液消失。对于有炎性颈部疼痛的患者,应考虑寰枢关节感染性关节炎的诊断。MRI表现对于诊断感染性寰齿关节具有重要意义。保守治疗,包括使用抗生素和颈部固定,对于寰枢关节化脓性关节炎的治疗可能就足够了。脑静脉血栓形成是寰枢关节感染性关节炎的一种罕见并发症。