IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Cervical spine dynamic instability in patient with rheumatoid arthritis

Case contributed by Andrew Dixon
Diagnosis certain

Presentation

Rheumatoid arthritis patient planning for intubation. ? cervical spine stability.

Patient Data

Age: 65
Gender: Female

C4-5 and C5-6 anterolistheses which reduce on extension and increase on flexion consistent with significant discoligamentous instability. No obvious median atlantoaxial joint instability demonstrated. 

Case Discussion

This case emphasizes the importance of assessing for cervical instability in rheumatoid arthritis patients prior to any planned intubation. This patient would have been at significant risk of cord injury if intubation was performed without this knowledge. 

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.