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.