Introduction: Pyogenic arthritis of the atlantoaxial joint is scarce. It can lead to serious complications such as spinal cord compression and cerebral vein thrombosis.
Case presentation: A 51-year-old man, presented with a twenty-day history of inflammatory neck pain. Physical examination revealed paravertebral muscle contracture, restricted neck movement, and fever. Spine MRI showed synovitis of atlanto-odontoid joint, anterior epidural collection, and cerebral vein thrombosis. Transthoracic echocardiography was unremarkable. The patient was successfully treated with anti-staphylococcal antibiotic treatment for twelve weeks associated with immobilization of the cervical spine. MRI performed one month after the initiation of the treatment showed a disappearance of the epidural collection.
Conclusion: The diagnosis of septic arthritis of the atlantoaxial joint should be considered in a patient with inflammatory neck pain. MRI findings are relevant in making the diagnosis of a septic atlanto-odontoid joint. Conservative treatment including antibiotic and neck immobilization can be sufficient for the treatment of pyogenic arthritis of the atlantoaxial joint. Cerebral vein thrombosis is a rare complication due to septic arthritis of the atlantoaxial joint.
Keywords: atlantoaxial joint, septic arthritis, jugular vein thrombosis
Key Clinical Message: We report here the case of a 51-year-old man presented with inflammatory neck pain and fever. Inflammatory biomarkers were increased. The magnetic resonance imaging showed synovitis of atlanto-odontoid joint and a cerebral vein thrombosis.