ATLANTO-AXIAL DISLOCATIONS: UNASSOCIATED WITH TRAUMA AND SECONDARY TO INFLAMMATORY FOCI IN THE NECK

Atlanto-axial dislocations in the absence of trauma, disease of the bone or congenital anomalies,¹ although occurring almost exclusively in children, have received little attention from pediatricians. A search of the medical literature resulted in our finding records of twenty-two cases. In addition, we report two of our own, diagnosed clinically with roentgenographic confirmation. Since the dislocations occur as a complication of certain acute diseases of childhood, prophylaxis and early recognition are incumbent on the pediatrician. No mention is made of this condition in the pediatric literature except in one French publication.² The cases have been reported under various descriptive names, such as malum suboccipitale rheumaticum,³ distention luxation of the atlanto-epistropheal joints,⁴maladie de Grisel,⁵Drehungsverrenkung des Atlas,⁶ spontaneous hyperemic dislocation of the atlas⁷ and nontraumatic atlanto-axial dislocation.⁸

Corner,⁹ in 1907, and Wittkop,¹⁰ in 1910, in exhaustive accounts of rotatory dislocations