Clinical Assessment of Atlantoaxial Instability by Sharp-Purser Test in Rheumatoid Arthritis.

, Moon, Myung Sang; , Park, Noh Kyoung; , Yu, Jang Hun; , Jo, In Han; , Kim, Jeong Hoon; , Jeon, Seung Hyuk; , Lee, Chan Woo

Original Article

Journal of the Korean Academy of Rehabilitation Medicine 2009;33(2):237-241.

Moon, Myung Sang , Park, Noh Kyoung , Yu, Jang Hun , Jo, In Han , Kim, Jeong Hoon , Jeon, Seung Hyuk , Lee, Chan Woo

Department of Rehabilitation Medicine, Sun General Hospital, Korea. drihcho@hanmail.net

Sharp-Purser검사를 이용한 류마티스성 환축추 불안정성의 임상적 평가

문명상,박노경,유장헌,조인한,김정훈,전승혁,이찬우

대전 선병원 재활의학과

Abstract

Objective
To evaluate the validity of Sharp-Purser test in the assessment of anterior atlantoaxial subluxation in rheu-matoid arthritis patients.
Method
We assessed the validity of the Sharp-Purser test in 38 rheumatoid arthritis patients who were subjected to stabilization surgery. All patients were evaluated using manual laxity test and re-evaluated radiologically.
Results
In 31 out of 38 patients (81.6%) Sharp-Purser test was positive in spite of anterior displacement of C1 over C2 on radiograms, while the tests were negative in 7. Among those 7 patients with negative test, 4 (10.5%) were acute cases and 3 (7.9%) were chronic cases with high grade hypomobile slip. Among the 31 patients with positive Sharp-Purser test, ADI (atlantodental interval) was 4 mm in 4 patients, 5 mm in 9, and greater than 5 mm in 18 patients. Among the 7 patients with negative Sharp-Purser test, ADI was 4 mm in 4 patients and greater than 5 mm in 3 patients.
Conclusion
Our results show that the Sharp-Purser test is a useful clinical examination to diagnose atlantoaxial insta-bility. (J Korean Acad Rehab Med 2009; 33: 237-241)

Key Words: Instability, Atlantoaxial, RA, Sharp-Purser test