Reddy Sl Sujitha, Pai B Sathish, Bhat N Shyamasunder, Pai Kanthilatha
Department of Dermatology, Venereology and Leprosy, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Department of Orthopaedics, Kasturba Medical College, Manipal, Manipal Academy of higher Education, Manipal, Karnataka, India.
J Orthop Case Rep. 2025 May;15(5):16-19. doi: 10.13107/jocr.2025.v15.i05.5538.
Behcet's disease (BD) is a chronic and multi-systemic disorder with inflammatory characteristics. It is manifested by recurrent oral aphthae, skin lesions, ocular disease, gastrointestinal involvement, neurological disorders, and vascular disease. Arthritis is seen in half of the patients. However, it rarely affects the spinal column, and patients presenting with neck pain have been reported only in one case in the literature.
Here we report a case of 39 year old male patient with BD whose primary symptom was neck pain. Anti-tubercular therapy was started empirically suspecting cervical tuberculosis. He was further evaluated as he was also developing skin and oral lesions. He was diagnosed to be having Behcet's disease and was started on colchicine, with which both his skin lesions and neck pain improved symptomatically.
This case emphasizes that despite atlanto-axial joint pain is a rare manifestation of BD, clinicians should suspect it a differential diagnosis in patients with neck joint pain along with mucous or cutaneous lesions. Accurate diagnosis and early management have to be done to prevent further joint dislocation and associated fatalities.
白塞病(BD)是一种具有炎症特征的慢性多系统疾病。其表现为复发性口腔溃疡、皮肤病变、眼部疾病、胃肠道受累、神经系统疾病和血管疾病。半数患者会出现关节炎。然而,它很少影响脊柱,文献中仅报道过1例以颈部疼痛为主要症状的患者。
在此,我们报告1例39岁男性白塞病患者,其主要症状为颈部疼痛。由于怀疑颈椎结核,经验性地开始了抗结核治疗。由于他还出现了皮肤和口腔病变,因此对其进行了进一步评估。他被诊断为白塞病,并开始服用秋水仙碱,其皮肤病变和颈部疼痛的症状均有改善。
该病例强调,尽管寰枢关节疼痛是白塞病的一种罕见表现,但临床医生在遇到伴有黏膜或皮肤病变的颈部关节疼痛患者时,应怀疑该病并进行鉴别诊断。必须进行准确诊断和早期治疗,以防止进一步的关节脱位及相关死亡。