LAUSR

Axial disease is common in children with established enthesitisrelated arthritis (ERA), but often arises later during the disease course. Here, we report a case of early atlantoaxial subluxation (AAS) that precedes severe uveitis in an adolescent male. A 13-year-old male started to complain of cervical spine pain, with progressive loss of motion. Due to the persistence of symptoms, 1 year later, a computerised tomography scan was done with the diagnosis of AAS. A hypothesis of post-traumatic aetiology was made despite the lack of history of high-energy impacts. He underwent surgery with rotatory fixation of cervical spine by Harms technique and the follow-up computerised tomography scan documented synostosis between C1 and C2. Six months later, he started to experience recurrent episodes of photophobia and ocular hyperaemia. Due to progressive visual impairment, a week before admission, an ophthalmology evaluation led to the diagnosis of severe left eye anterior uveitis with iridolenticular synechiae and band keratopathy (Fig. 1a,b) and topical steroid treatment was started. Due to severe visual impairment (left eye 1/10) and severe cystoid macular oedema at the optical coherence tomography (Fig. 1c), the patient was