Four cases of atlanto-occipital dislocation are described. Two of the cases were found in a material of 407 patients with rheumatoid arthritis indicating a frequency of 0.5 per cent. All the patients had severe mutilating changes of the peripheral joints as well as of the cervical spine and all developed severe neurologic symptoms. The diagnosis is not easy to set on conventional films so conventional tomography or rather computed tomography is recommended.
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