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Case Reports
. 2024 Aug 1;63(8):e212-e214.
doi: 10.1093/rheumatology/keae026.

A dens fracture case solved

Ling Oei  1 , Jiawei Li  1 , A Faiz Karim  2 , Robert M Verdijk  3 , Edwin H G Oei  4 , Jan A M van Laar  1   5 , David Ten Cate  6   7 , Iain Haitsma  8 , Dominiek A Monserez  9 , M Carola Zillikens  1
Affiliations
Case Reports

A dens fracture case solved

Ling Oei et al. Rheumatology (Oxford). .
No abstract available

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Figures

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Graphical abstract
Figure 1.
Figure 1.
Imaging and histopathological results of the dens and surrounding tissues. I. CT scans of the dens. (A) Initial CT shows degenerative changes of the C1–C2 joint with small calcifications. (B) Low-dose CT shows lucency of the dens as a first sign of osteolysis. (C) Destructive and expansive osteolysis of the dens and anterior atlas arose. (D) With 2 months of prednisolone treatments, a radiological improvement with more ossification was seen. Yet the non-union fracture remained. II.  18F-FDG PET/CT. (A)  18F-FDG PET/CT without prednisolone treatment showed avid FDG uptake in and around the dens. (B) PET/CT without prednisolone additionally showed avidity in the medial rectus eye muscle. (C) MRI showed an enlargement of the pituitary. III. Histopathology results of the dens and surrounding tissues. (A) Haematoxylin and eosin staining showed scattered moderate infiltration of bone with lymphocytes and plasma cells. (B) IgG immunostaining showed IgG-positive plasma cells. (C) IgG4 immunostaining showed IgG4-positive plasma cells within the tissues
See this image and copyright information in PMC

References

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