A woman with a bamboo spine in the thoracic vertebra and normal sacroiliac joint; a 5-years undiagnosed ankylosing spondylitis: Case report and literature review

Abstract

The term "spondyloarthropathy" refers to several often overlapping diseases that commonly produce inflammation in different areas of the body such as sacroiliac joints (sacroiliitis), axial spine (spondylitis), tendon, fascia, ligament insertion sites (enthesitis), oligoarthritis, rash (erythema nodusum), and uveitis. Because the rheumatoid factor is negative, the term seronegative spondyloarthritis has been used to refer to such cases in the past, which have included ankylosing spondylitis, psoriatic arthritis, inflammatory bowel disease arthritis, and reactive arthritis [1]. Ankylosing spondylitis (AS) is an inflammatory disease affecting various parts of the body, including the spine, peripheral joints, eyes, tendon, and cardiovascular system [2, 3]. The initial symptoms of the AS include pain in the axial joints and limitation of movement. The pathogenesis of this disease is unclear, however, human leukocyte antigen B27 (HLA-B27) has been found in 90% of AS patients [4]. The disease usually begins late in the second or third decade of life [5] and is reported to affect twice as many men as women [6]. Radiographic findings of the disease occur in a specific order: widening of the sacroiliac joint generally happens first, followed by erosion, sclerosis, and eventually ankylosis. Inflammation caused by AS ultimately leads to the formation of new bones around the joints. Ossification in the joints and ligamentous structures of the vertebrae causes the formation of syndesmophytes, which can connect with each other allowing for specific radiographic findings [7-9]. Case Reprt Open Access Ankylosing spondylitis (AS) is a chronic inflammatory disease that causes deterioration in the function of the spine and peripheral joints. In addition to history and examination, imaging is important in diagnosing this disease. Pelvic X-rays in particular may show pseudowidening, erosion, and sclerosis sacroiliac joint. Spinal X-rays may also identify syndesmophytes. In more advanced stages, the spine may also be involved, forming a specific type of disease called "bamboo spine". The New York criteria, which includes radiologic and clinical criteria, are used to diagnose AS. The distribution of involvement in joints and bones in AS varies, but classically, it is ascending from the sacroiliac joint, lumbar, and thoracic region. Herein, we report a case of AS that was undiagnosed for 5 years. Despite the normal appearance of the sacroiliac joint, severe involvement of the spinal column in the thoracic region known as "bamboo spine" was observed. The time order of bone involvement in this patient is contrary to what is usually seen. Based on the New York criteria for AS, the case under discussion is not included in the AS definition; however, the patient had clinical symptoms of AS, bamboo spine, and showed a dramatic response to treatment of AS. Heeding the course of the AS as well as the clinical signs and imaging results of various areas (heart, lumbar spine, and sacroiliac joint) will help physicians diagnose AS accurately and in...

Neuroradiological manifestations of neuroinflammatory diseases; A concept for rare cases and neuro-COVID-19

“…Despite the sacroiliac joint's typical look, substantial spinal column involvement in the thoracic area known as the "bamboo spine" was observed. In that patient, the time sequence of SPINE involvement is reversed from what is often observed [13].…”

Aggressive Osteoblastoma in adolescents: Radiological case report

“…Khin et al described a case of aggressive Osteoblastoma in the humerus with radiological features similar to osteosarcoma [16]. When consider the imaging, we should consider some bone involvement in spine can present in different orders of routines, such as neuroinflammation of vertebra in other diseases [20].…”

The role of Neuroradiology in Neuroplasticity: New advancements

“…More functional activation during certain tasks has been regarded as an adaptive plasticity mechanism to counteract greater tissue damage. The radiologic manifestations of a neuroinflammatory illness might reveal themselves in any sequence and without provocation [18]. MS causes gradual brain atrophy in the early stages of the illness, resulting in physical and cognitive impairment.…”