Help with cervical spine please

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64 year old female with neck and shoulder pain who has diffuse sclerosis in
cervicl vertebral bodies C3-7 with psparing od C1 and 2 and posterior
elements.
Old X-Ray 9 years ago shows early proliferation C5-6
CT 3 years ago demonstrated proliferative changes similar to current study.
Hot on bone scan, looks active on MR but negative soft tissue biopsy and
marrow aspirate.
It has been called DISH but does not look like it to me.
Any suggestions ??

help appreciated

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2 thoughts on “Help with cervical spine please”

  1. OCAD
    gblumenau

    Hi
    For sure, it doesn’t look like DISH.
    Is there any other history of chronic metabolic bone disease, like fluorosis?

    Best
    Gustavo

  2. drrobjones1

    64 year old female with neck and shoulder pain who has diffuse sclerosis in
    cervicl vertebral bodies C3-7 with sparing of C1 and 2 and posterior
    elements.
    Old X-Ray 9 years ago shows early proliferation C5-6
    CT 3 years ago demonstrated proliferative changes similar to current study.
    Hot on bone scan, looks active on MR but negative soft tissue biopsy and
    marrow aspirate.
    It has been called DISH but does not look like it to me.

    Thanks all for suggestions which include:
    Seronegative arthritis/psoriatic (4)
    SAPHO (7)
    Brucellosis
    Blastomycosis
    Pagets
    Hypervitimosis A

    I.m going to push for a biopsy and I’ll let you know

    cheers,

    RobJ

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