A woman with speech and swallowing disorder

Abstract A 78-year-old woman with a history of rheumatoid arthritis has been developing progressive speech and swallowing problems since 3 weeks. A CT scan of her head and neck showed a subluxation of the dens, which caused basilar invagination. This severe complication of rheumatoid arthritis is rare. Dynamic imaging and neurologic survey are recommended in patients with rheumatoid arthritis.