IS Case 359: Ankylosing Spondylitis

Aharon Wolf, MD

2009 URMC Imaging Sciences
Publication Date: 2010-03-01

History

Patient is a 55-year-old male presenting with lower back pain and stiffness that is worse in the morning and improves after movement.

Findings

Frontal and lateral views of spine demonstrate bambooing of the spine and fusion of the bilateral sacroiliac joints. There is calcification of the intervertebral discs.

Discussion

Ankylosing spondylitis is an inflammatory rheumatic disease that affects the axial skeleton, causing characteristic inflammatory back pain. The hips and shoulders are affected in about one third of people with ankylosing spondylitis. Poor chest wall movement may result in decreased vital capacity. In the past decade new therapies have changed the management of this disease. Treatment with non-steroidal anti-inflammatory agents and physiotherapy remains the main long-term management of patients with ankylosing spondylitis. Possible new treatment options including tumor necrosis factor (TNF) blockers have recently been shown to be promising for patients refractory to conventional treatment.

References

  1. Braun J, Sieper J. Ankylosing spondylitis. Lancet. 2007 Apr 21;369(9570):1379-90. PMID: 17448825

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