Odontoid fracture and C1-C2 subluxation in psoriatic cervical spondyloarthropathy. A case report.

Study Design: Case presentation and review of pertinent literature.

Objectives: To present an unusual case and alert other physicians to possible missed diagnoses.

Summary Of Background Data: An unusual case is presented of a young man with server psoriatic spondyloarthropathy and fusion of C2-C7 (Type II cervical psoriatic ankylosing disease) who fell at home, sustaining an unrecognized fracture of the odontoid process leading to subluxation of C1-C2 and the transitory tetraplegia. The patient presented with torticollis, and the fracture was unrecognized for a long period of time.

Methods: Case presentation.

Results: This patient became independent in all activities of daily living after surgery and rehabilitation despite persistence of torticollis.

Conclusions: A patient who presents clinically with traumatic torticollis after minor trauma and who also has psoriasis and ankylosis of the cervical spine should be suspected of having a fracture-subluxation until definitely proven otherwise. In the present case, the late diagnosis delayed surgical stabilization.