Age: 29
Sex: Male
Indication: Back pain
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Case #22
Findings
- T2/STIR signal hyperintensity in the anterosuperior and anteroinferior corners of the T5-T6, T8-T10, and T12-L2 vertebral bodies
- T2/STIR signal hyperintensity about the left T3-T4 costovertebral joint and to a lesser extent about the costovertebral joints bilaterally at T5-T6, on the right at T7-T8, and on the left at T9-T10
- Likely multilevel bridging anterior syndesmophytes
- Normal alignment
- Normal cord signal
- Disc spaces are maintained
Diagnosis
- Ankylosing spondylitis
Sample Report
Edema in the anterior aspects of the endplates about the T5-T6, T8-T9, T9-T10, T12-L1, and L1-L2 intervertebral discs, edema about multiple bilateral costovertebral joints most pronounced on the left at T3-T4, and likely multilevel bridging anterior syndesmophytes. These findings are most suggestive of an inflammatory spondyloarthropathy, particularly ankylosing spondylitis. Recommend rheumatology evaluation.
Given the increased vulnerability to fractures in patients with ankylosing spondylitis, dedicated CT imaging should be considered for further evaluation if there is a history of trauma.
No abnormal cord signal or significant mass effect on the thecal sac in the thoracic spine.
Discussion
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