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Osteomyelitis of the Atlantooccipital Joint in an Intravenous Drug UserA Case Report and Review of the Literature
Tiago Ribeiro Barbosa, MD1; Paulo Miguel Pereira, MD2; Pedro Santos Silva, MD2; Pedro Miguel Monteiro, MD2; Rui Manuel Vaz, MD, PhD2
1 Department of Orthopaedic Surgery, Centro Hospitalar do Alto Ave, Rua dos Cutileiros, Creixomil, 4835-044 Guimarães, Portugal. E-mail address: atiagobarbosa@gmail.com
2 Department of Neurosurgery, Centro Hospitalar de São João, Alameda Professor Hêrnani Monteiro, 4200-219, Porto, Portugal. E-mail address for P.M. Pereira: pereira.paulom@gmail.com. E-mail address for P.S. Silva: pedrodossantossilva@gmail.com. E-mail address for P.M. Monteiro: pedrommon@gmail.com. E-mail address for R.M. Vaz: ruimcvaz@gmail.com
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Investigation performed at Centro Hospitalar de São João, Porto, Portugal

Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
JBJS Case Connector, 2013 Oct 23;3(4):e101 1-6. doi: 10.2106/JBJS.CC.M.00075
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Vertebral osteomyelitis accounts for approximately 1% to 7% of all bone infections. Pyogenic osteomyelitis of the cervical spine is rare, representing 5.9% of spinal cases; 35% of these cases occur in the thoracic spine, and 57% occur in the lumbar spine. The occurrence in the upper cervical spine is even more rare, accounting for only 0.7% of cases1-3. In patients with a history of intravenous drug use, the involvement of the cervical spine is more frequent and may be as high as 27%4.
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