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A Case of Grisel Syndrome Showing No Underlying Laxity of the Atlanto-axial Joint

Authors
Ahn, AR | Park, YH | Park, EJ | Yim, SY
Citation
Annals of rehabilitation medicine, 41(3). : 511-515, 2017
Journal Title
Annals of rehabilitation medicine
ISSN
2234-06452234-0653
Abstract
Grisel syndrome is a rare, non-traumatic atlanto-axial subluxation associated with an inflammatory or infectious process in the upper neck. According to the two-hit hypothesis, which is widely accepted for the pathogenesis of Grisel syndrome, preexisting ligamentous laxity of the atlanto-axial joint is regarded as the first hit. An inflammatory or infectious process of the atlanto-axial joint acts as the second hit, resulting in non-traumatic atlanto-axial subluxation. We report on a 6-year-old girl with atlanto-axial subluxation following retropharyngeal and cervical lymphadenitis. She was diagnosed with Grisel syndrome, for which an initial computed tomography did not show any preexisting ligamentous laxity of the atlanto-axial joint. A literature review found only 4 case reports on Grisel syndrome with an initially normal atlanto-axial joint. The present case offers some evidence that a single hit, such as inflammatory changes in the atlanto-axial joint, might cause Grisel syndrome, even without underlying ligamentous laxity.
Keywords
DOI
10.5535/arm.2017.41.3.511
PMID
28758092
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Physical Medicine & Rehabilitation
Ajou Authors
임, 신영
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