Atlantoaxial Instability in a Patient with Neck Pain and Ankylosing Spondylitis.

Atlantoaxial Instability in a Patient with Neck Pain and Ankylosing Spondylitis. Mil Med. 2018 Mar 26;: Authors: Lyons C, Ross M, Elliott R, Tall M Abstract The purpose of this report is to describe the evaluation and treatment of a patient with neck pain and ankylosing spondylitis who had underlying atlantoaxial instability. The patient was a 31-yr-old man diagnosed with ankylosing spondylitis 1 yr prior who was referred to a physical therapist for the treatment of chronic, worsening low back and hip pain. He also had secondary complaints of neck, upper back, and shoulder pain. The patient worked as a military pilot. As part of the patient's physical examination, a Sharp-Purser test was performed, which was positive for excessive motion. Diagnostic imaging confirmed the atlantoaxial instability; it was also determined that the patient's atlanto-occipital joints were fused. Despite evidence of atlantoaxial instability, it was determined the patient would be managed through nonsurgical interventions. The patient was prescribed etanercept by his rheumatologist and the physical therapist developed a comprehensive rehabilitation program that addressed relevant impairments of the spine, hips, and shoulders. At 3 yr following his initial evaluation with the physical therapist, the patient continued to report minimal bodily pain and no limitations in his functional capabilities. Additionally, the patient had earned a high profile flying pos...
Source: Military Medicine - Category: International Medicine & Public Health Tags: Mil Med Source Type: research