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Ankylosing spondylitis

Case contributed by Ganesh Sanap
Diagnosis certain

Presentation

75 years male patient presents with gradually progressive backache with stiffness.

Patient Data

Age: 75 years
Gender: Male

Ankylosing spondylitis

x-ray

Vertebral body fusion by marginal syndesmophytes gives the classical Bamboo spine appearance in ankylosing spondylitis.

Ossification of supraspinous and interspinous ligaments gives Dagger sign.

Subchondral erosions, sclerosis and proliferation on the iliac side of SI joints.

Case Discussion

The findings of bamboo spine, dagger sign, syndesmophytes, bilateral sacroiliitis with clinical history are suggestive of ankylosing spondylitis.

Patient's laboratory evaluation shows :

HLA-B27: Positive.

C-Reactive protein: 6.1 (positive).

R.A.Factor : < 20, negative

ESR: 12, raised (0 to 10 normal as per lab standards)

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