Korean J Spine.  2013 Jun;10(2):85-87. 10.14245/kjs.2013.10.2.85.

Hemorrhagic Synovial Cyst Associated with Rheumatoid Atlantoaxial Subluxation

• Sheen JJ
• Seo DK
• Rhim SC
• Choi SH

• KMID: 1412546
• DOI: http://doi.org/10.14245/kjs.2013.10.2.85

Abstract

Synovial cyst on prevertebral space of C1-2 joint is rare but may be associated hemorrhagic event. We describe a case of a 72-year-old woman who presented with sudden severe headache in her left occipital area with dyspnea. She had rheumatoid arthritis for 14-years. Large hemorrhagic cystic mass was seen around prevertebral space of the atlantoaxial joint on the left side on cervical MRI (magnetic resonance image) and it obstructed the nasopharyngeal cavity. Aspiration of the cystic lesion was performed via transoral approach, followed by posterior occipito-cervical fusion. The specimen was xanthochromic, suggesting old hemorrhage. The patient was tolerable on her postoperative course and showed good respiration and relieved headache. We suggest that repeated microtrauma due to atalantoaxial subluxation associated with rheumatoid arthritis as a main cause of hemorrhagic event on the cyst.

Keyword

Atlanto-Axial joint; Hemorrhage; Rheumatoid arthritis; Synovial cyst

MeSH Terms

Arthritis, Rheumatoid
Atlanto-Axial Joint
Dyspnea
Female
Headache
Hemorrhage
Humans
Joints
Respiration
Synovial Cyst