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Craniocervical instability is more common in people with a connective tissue disease, including Ehlers-Danlos syndromes, [1] osteogenesis imperfecta, and rheumatoid arthritis. [2] It is frequently co-morbid with atlanto-axial joint instability, Chiari malformation, [3] or tethered spinal cord syndrome.
Atlantoaxial instability is a common asymptomatic finding in rheumatoid arthritis patients. [3] However, it can lead to cervical myelopathy . [ 4 ] Patients with atlantoaxial instability can experience neck pain and headaches in the back of the head (occipital headaches).
Excessive laxity of the posterior transverse ligament can lead to atlantoaxial instability, a common complication in patients with Down Syndrome and Ehlers–Danlos syndrome. Laxity has also been hypothesized as the cause of degenerative hypertrophy and mechanical atlantoaxial stress. [3]
The median atlanto-axial joint is sometimes considered a triple joint: [3] one between the posterior surface of the anterior arch of atlas and the front of the odontoid process; one between the anterior surface of the ligament and the back of the odontoid process; The lateral atlantoaxial joint involves the lateral mass of atlas and axis. [4]
Deformities of the spine, such as scoliosis (curvature of the spine), kyphosis (a thoracic hump), tethered spinal cord syndrome, craniocervical instability (CCI), and atlantoaxial instability may also be present. [48] [49] Osteoporosis and osteopenia are also associated with EDS and symptomatic joint hypermobility [50] [51]
The atlanto-occipital joint may be dislocated, especially from violent accidents such as traffic collisions. [1] This may be diagnosed using CT scans or magnetic resonance imaging of the head and neck. [1]
Hamm took a drug test that weekend, knowing he would fail. A week later, he delivered himself to his probation officer and soon after he was booked into the Campbell County jail. But before that, he had called Greenwell, Grateful Life’s intake supervisor. Hamm had begged to be allowed back into the program. Greenwell had turned him down.
Grisel's syndrome is a non-traumatic subluxation of the atlanto-axial joint caused by inflammation of the adjacent tissues. This is a rare disease that usually affects children. Progressive throat and neck pain and neck stiffness can be followed by neurologic symptoms such as pain or numbness radiating to arms (radiculopathies).