RESUMO
Severe neck pain, worsened by head rotation, may signal atlantoaxial joint involvement, prompting differentiation between inflammatory and mechanical causes. This study challenges conventions by presenting three cases where inflammatory diseases, typically associated with extremities, affect the atlantoaxial joint. Cases involve a 64-year-old woman with crowned dens syndrome (CDS) due to calcium pyrophosphate crystals, a 69-year-old male with septic arthritis at the C1-2 level and an 82-year-old female with rheumatoid arthritis (RA). Despite shared severe neck pain, patients with CDS and septic arthritis show notable neck rotation limitations, while the RA patient experiences joint pain without such constraints. Diagnostic methods include cervical computed tomography (CT) for CDS, and various imaging and blood tests for septic arthritis, and American College of Rheumatology/European League Against Rheumatism criteria (ACR/EULAR) for RA. These cases highlight atypical inflammatory manifestations at the atlantoaxial joint, urging consideration in severe neck pain scenarios.
RESUMO
When a patient represents pain in foot, physician can easily overlook compression neuropathy of peripheral nerve as it is uncommon. Among nerve entrapment syndrome encountered in the foot, selective compression in lateral branch of deep peroneal nerve (DPN) is rare. We report a case of a patient with pain and dysesthesia in dorsolateral foot which turned out as lateral branch of deep peroneal nerve entrapment syndrome caused by talonavicular joint effusion. We would like to share diagnostic work up flow and conservative treatment courses. This case manifests the importance of the deep peroneal nerve and its branches in clinical setting of pain and ankle instability.
