Portal de Periódicos da CAPES

Radiological assessment of the atlantoaxial distance in Down's syndrome.

1993; BMJ; Volume: 69; Issue: 3 Linguagem: Inglês

10.1136/adc.69.3.347

1468-2044

M. J. G. Cremers, Luis González Ramos, E. Bol, J van Gijn,

Connective tissue disorders research

People with Down9s syndrome are pre-disposed to atlantoaxial instability. As part of a study to determine whether those with Down9s syndrome should be screened for atlantoaxial instability before they participate in sport, a series of 279 children, aged 6 to 17 years was investigated radiologically. Lateral radiographs of the cervical spine were taken in neutral position and in flexion. The magnification factor was assessed by means of a marker attached to the nape of the neck. After correction for magnification 15% of the patients were found to have an atlantoaxial distance greater than 4 mm on the flexion film, especially boys under 11 years of age. However, sex and age together explained at most 9% of the variation in atlantoaxial distance. The maximum distance found was 6.5 mm. The disagreement between the means of first and second measurements by the same (test-retest) and by another (inter-) observer was more for those taken in the neutral position than in flexion. On a group level the results for reliability were satisfactory.