A case of osteomalacia mimicking ankylosing spondylitis

Abstract

A 39-year-old woman presented with symptoms of pain in the lumbar region and lower extremities. Physical findings included restricted movement of the lumbar spine, sacroiliac joint tenderness, positive Schober's test (10-12.5 cm), and bilaterally positive Mennel and Fabere tests. Although these symptoms and findings were suggestive of ankylosing spondylitis, osteomalacia was diagnosed with the appearance of multiple pseudofractures in her pelvic X-ray and laboratory abnormalities. All her symptoms and signs resolved in 6 months with vitamin D and calcium treatment.

Electrical twitch obtaining intramuscular stimulation (ETOIMS) for myofascial pain syndrome in a football player: Figure 1

“…FABERE assesses the flexibility of major muscles crossing the hip, knee, and lower back and is impaired in lower back pain. 10 In spite of complete pain relief after 10 ETOIMS sessions, FABERE continues to be limited in our patient, indicating that chronic muscle tightness is more difficult to treat and may predispose the athlete to recurrent injuries. Although pain-free, the patient chose to continue long term ETOIMS treatment for symptoms of muscle tightness which helped to maintain range of motion, avoided pain recurrence, and provided satisfactory athletic performance.…”

Sacroiliac joint pathologies in low back pain

“…In the rheumatic group, patients were diagnosed as ankylosing spondylitis (21), undifferentiated spondyloarthropathy (11), psoriatic arthropathy (5), reactive arthropathy (1) and juvenile spondyloarthropathy (2). The non-rheumatic group consisted of osteitis condensus ilii (4), osteomalacia (2), tubercular infection (2), pyogenic infection (1), pregnancy related SIJ pain (2) and malignancy (1) ( Table 1).…”

“…The non-rheumatic group consisted of osteitis condensus ilii (4), osteomalacia (2), tubercular infection (2), pyogenic infection (1), pregnancy related SIJ pain (2) and malignancy (1) ( Table 1).…”

“…Reports of cases with osteomalacia and sacroiliitis are available in the literature [2,11]. Tuberculosis and osteomalacia should be kept in mind in the setting of developing countries.…”

Sacroiliac dysfunction

“…Calcium pyrophosphate crystal deposition disease, sarcodosis,ochronosis, hyperparathyroidism, paget disease, osteomalacia, acromegaly are other pathologies that can affect the sacroiliac joints (1,9,18,39,40,73) .…”