Question:
Atlanto-axial subluxation is commonly encountered in the following conditions EXCEPT
Atlanto-axial subluxation is commonly encountered in the following conditions EXCEPT
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Three of these are inflammatory or infective causes of ligament laxity at C1-C2; one is a crystal arthropathy that spares this joint.
Updated On: Jul 16, 2026
- Ankylosing spondylitis
- Gout
- Rheumatoid arthritis
- Retropharyngeal abscess
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The Correct Option is B
Solution and Explanation
Step 1: Understanding the Question:
The question asks which of the four listed conditions is NOT a recognised cause of atlanto-axial subluxation, a condition in which the C1 (atlas) and C2 (axis) vertebrae lose their normal alignment, usually because the ligaments or bone holding the odontoid process in place are weakened.
Step 2: Key Concept or Approach:
Atlanto-axial subluxation results from anything that damages the transverse ligament, erodes the odontoid peg, or destabilises the C1-C2 joint — inflammatory arthritis and chronic infection near the joint are the usual culprits. Recognising which diseases actually attack this ligament-bone complex, versus which spare it, is the key to answering this EXCEPT question.
Step 3: Working Through the Options:
Rheumatoid arthritis is the classic and most common cause of atlanto-axial subluxation: chronic synovitis forms a pannus that erodes the transverse ligament and the odontoid process, letting the atlas slip forward on the axis. Ankylosing spondylitis is also a well-recognised cause, since the same inflammatory process that fuses the lower spine can destabilise the upper cervical joints as well. Retropharyngeal abscess causes it through Grisel syndrome, seen mainly in children, where infection and inflammation around the C1-C2 joint loosen the transverse ligament and allow subluxation even without direct bone destruction. Gout, in contrast, is a crystal arthropathy that typically involves peripheral joints such as the great toe, ankle, and knee; it very rarely affects the atlanto-axial joint and is not considered a standard cause of this subluxation.
Step 4: Conclusion:
Since the question asks for the exception, the correct answer is gout.
The question asks which of the four listed conditions is NOT a recognised cause of atlanto-axial subluxation, a condition in which the C1 (atlas) and C2 (axis) vertebrae lose their normal alignment, usually because the ligaments or bone holding the odontoid process in place are weakened.
Step 2: Key Concept or Approach:
Atlanto-axial subluxation results from anything that damages the transverse ligament, erodes the odontoid peg, or destabilises the C1-C2 joint — inflammatory arthritis and chronic infection near the joint are the usual culprits. Recognising which diseases actually attack this ligament-bone complex, versus which spare it, is the key to answering this EXCEPT question.
Step 3: Working Through the Options:
Rheumatoid arthritis is the classic and most common cause of atlanto-axial subluxation: chronic synovitis forms a pannus that erodes the transverse ligament and the odontoid process, letting the atlas slip forward on the axis. Ankylosing spondylitis is also a well-recognised cause, since the same inflammatory process that fuses the lower spine can destabilise the upper cervical joints as well. Retropharyngeal abscess causes it through Grisel syndrome, seen mainly in children, where infection and inflammation around the C1-C2 joint loosen the transverse ligament and allow subluxation even without direct bone destruction. Gout, in contrast, is a crystal arthropathy that typically involves peripheral joints such as the great toe, ankle, and knee; it very rarely affects the atlanto-axial joint and is not considered a standard cause of this subluxation.
Step 4: Conclusion:
Since the question asks for the exception, the correct answer is gout.
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