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Backward luxation of the atlas would appear to be an extremely rare con dition. A number of authors mention the infrequency of backward luxation as compared to the more common forward luxation although no single unequiv ocal report of this condition could be found in an extensive study of the literature. According to MALGAIGNE (1) a case was described in 1850 by MELCHIORI in Italy ; it was not possible however to obtain the original of this paper. There would therefore appear to be some justification for the publica tion of the present case in which post-mortem confirmation of the diagnosis was possible. Case reportA 66-year-old houswife with a history of recurrent rheumatoid arthritis since the age of 28. She had had several attacks, for which she had received gold, salicylates and pyridine deriv atives, followed by stiffness of the joints particularly the knees, left shoulder, wrists and interphalangeal joints. She was admitted with severe pain in the nuchal region, tender and swollen knees and a temperature of 39° C. The sedimentation rate was 132 mm/hours and the Rose

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