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Commentary |

Should Children With Down Syndrome Be Screened for Atlantoaxial Instability?

Siegfried M. Pueschel, MD, PhD, JD, MPH
Arch Pediatr Adolesc Med. 1998;152(2):123-125. doi:10.1001/archpedi.152.2.123.
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In 1995, the Committee on Sports Medicine and Fitness of the American Academy of Pediatrics (AAP) published a position paper1 on atlantoaxial instability in children with Down syndrome in which a previous statement on the same subject published in 19842 (Table 1) was retired. The 1995 statement includes several arguments that disfavor screening of children with Down syndrome for atlantoaxial instability.1 Whereas some of these arguments are well founded, others lack substantive evidence that would support the statement. In the following discussion, I attempt to analyze some of these arguments made in the 1995 statement and provide a viewpoint that favors radiologic examinations of the cervical spine of children with Down syndrome.

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