Hi OCADers,
I have a case, together with Dr. Robinson from Australia, that might look like axial spondyloarthritis (ank spond) at first glance, but certain features do not fit.
22-year-old Caucasian male with no known history of psoriasis, experiencing stiffness of the spine and inflammatory back pain.
Please see all images here:
https://bcv.app/s227M3
I don’t believe it is a case of axSpA, as the SIJs are normal. Slight signal increases near the joints on MRI water-sensitive changes are probably due to apophyses that are still non-fused.
Psoriatic spondyloarthritis or SAPHO/CNO? I’m not sure – especially as we know little about the skin.
There is severe kyphosis and defects of the endplates that resemble Schmorl’s nodes, which are compatible with Scheuermann’s kyphosis (Edgren-Vaino configuration). But I did never see ankylosis in Scheuermanns. Also, there is significant edema in the vertebrae, a feature sometimes seen in Scheuermann’s but, of course, more frequently in axSpA.
Calling all pediatric radiologists if they have another idea?!
Thank you!
Kay.
