DYSPHAGIA DUE TO VERTICAL SUBLUXATION OF THE AXIS IN RHEUMATOID ARTHRITIS

Two patients with rheumatoid arthritis developed swallowingdifficulties. These were mild in one case but severe in theother. Associated pyramidal tract signs and striking upwardtransloca-tion of the dens made it seem probable that dysphagiawas attributable to medullary compression despite the absenceof other bulbar features. A history of dysphagia may thereforehave serious implications for patients with rheumatoid disease.