A missed unstable cervical vertebra fracture in a patient with ankylosing spondylitis
Graat, H.C.A.; van Bommel, E.; Pöll, R.G.
Nederlands Tijdschrift Voor Geneeskunde 149(34): 1903-1907
2005
ISSN/ISBN: 0028-2162 PMID: 16136744 Document Number: 592857
A 53-year-old man with a 13-year history ofankylosing spondylitis presented to the emergency clinic of another hospital because of neck pain after a fall from a low stepladder. The patient was put at ease and discharged after physical examination and X-ray of the cervical spine revealed nothing out of the ordinary. Because his neck pain persisted, the patient contacted his rheumatologist. New cervical X-rays revealed fractures of the body and articular process of CVI and CVII. The patient was referred to our hospital for orthopaedic treatment. The fractures healed during 2.5 months' treatment with halotraction and a halovest. All patients with ankylosing spondylitis with neck pain after trauma have an unstable cervical fracture until proven otherwise. Cervical fractures should be excluded in all cases and other diagnostic tools (CT-scan or MRI) must be used whenever necessary.