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Title : Case 111

Age / Sex : 81 / M


Age/Sex : 81/male


 

Chief complaint: back pain after motorcycle TA.




1) What is your impression?

Two weeks later, you can see the final diagnosis with a brief discussion of this case.

* Send Application Answers to Ja-Young Choi, MD (drchoi01@gmail.com)


Courtesy: In-Sup Song, MD., Chung-Ang University Hospital


Diagnosis:

Ankylosing spondylitis in T and L spine with fracture.



Discussion


Findings :
T-L spine AP and lateral view: Bamboo spine, ossification of interspinous and supraspinous ligament, Fracture through L1 upper body to T12 and L1 posterior elements.


 


Diagnosis : Ankylosing spondylitis in T and L spine with fracture.


 


Discussion :
 Initial radiographic finding of spinal involvement is squaring of the anterior surface of vertebral body on the lateral view. Later, syndesmophytes form from ossification in the outer layers of the annulus fibrosus of the disc. When extensive, bamboo spine appearance. The apophyseal joints become ankylosed, and the interspinous and paraspinous ligaments ossify.As the joint fuse, the spine become susceptible to fracture that occur through the ankylosed disc and posterior elements.


 

Reference :
 pp. 99-103, Paul and Juhl’ Essential radiology imaging

Correct Answer
Name Institution
Total Applicants (15)
Correct Answer (15)
김완태: 서울보훈병원
김성준: 영동세브란스병원
김수진: 서울대병원
김재원: 강남성심병원(전공의)
박상현: 순천향대학천안병원(전공의)
오경진: 분당서울대병원
이승훈: 고려대부속구로병원
이호준: 여의도동에 사시는 전공의 선생님
임재훈: 전남대학교병원(전공의)
정수진: 전남대학교병원(전공의)
정혜원: 서울아산병원
채지원: 보라매병원
최수정: 강릉아산병원
최희석: 분당서울대병원
하종수: S서울병원

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