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KMID : 0361420090330020237
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Journal of Korean Academy of Rehabilitation Medicine
2009 Volume.33 No. 2 p.237 ~ p.241
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Clinical Assessment of Atlantoaxial Instability by Sharp-Purser Test in Rheumatoid Arthritis
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Moon Myung-Sang
Park Noh-Kyoung
You Jang-Hun
Jo In-Han
Kim Jeong-Hoon
Jeon Seung-Hyuk
Lee Chan-Woo
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Abstract
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OBJECTIVE: To evaluate the validity of Sharp-Purser test in the assessment of anterior atlantoaxial subluxation in rheumatoid 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 instability.
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KEYWORD
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Instability, Atlantoaxial, RA, Sharp-Purser test
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