Atlantoaxial subluxation in Reiter's syndrome. A report of three cases and review of the literature

Three patients with the unusual manifestation of atlantoaxial subluxation in Reiter's syndrome are studied. Each patient had mild symptoms referable to the cervical spine and radiologic evidence of erosive disease elsewhere in the skeleton. One patient had an 11-year history of Reiter's syndrome when the atlantoaxial subluxation was detected. The other two had atlantoaxial subluxation detected within 1 year of initial presentation, at variance with three other such patients that were reported previously, in whom there was a 6- to 10-year interval from initial presentation until radiographic documentation of atlantoaxial subluxation. Cervical spine radiographs, including flexion and extension views, are recommended for all patients with Reiter's syndrome and cervical spine symptoms.