An atypical psoriatic spondylitis case, successfully treated with methotrexate

We present a 45-year-old male patient who was hospitalized with lumbar disc herniation and whose control magnetic resonance imaging (MRI) findings initially suggested brucella spondylitis. Definitive diagnosis, however, indicated psoriatic spondylitis and the patient was successfully treated with me...

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Bibliographic Details
Published in:Clinical rheumatology 1996-07, Vol.15 (4), p.403-409
Main Authors: Tüzün, C, Peker, O, Küçüktaş, F, Gülbahar, S, Kovanlikaya, I, Füzün, S
Format: Article
Language:English
Subjects:
Antirheumatic Agents - therapeutic use
Arthritis, Psoriatic - diagnosis
Arthritis, Psoriatic - drug therapy
Arthritis, Psoriatic - etiology
Humans
Intervertebral Disc Displacement - complications
Intervertebral Disc Displacement - diagnosis
Lumbar Vertebrae - diagnostic imaging
Lumbar Vertebrae - pathology
Magnetic Resonance Imaging
Male
Methotrexate - therapeutic use
Middle Aged
Radiography
Radionuclide Imaging
Spondylitis - diagnosis
Spondylitis - drug therapy
Spondylitis - etiology
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Summary:We present a 45-year-old male patient who was hospitalized with lumbar disc herniation and whose control magnetic resonance imaging (MRI) findings initially suggested brucella spondylitis. Definitive diagnosis, however, indicated psoriatic spondylitis and the patient was successfully treated with methotrexate. A diagnosis of lumbar disc herniation was made in May 1991, during his psoriasis vulgaris treatment. He was hospitalized in August 1994 with a complaint of low-back pain persisting over the last six months despite treatment with analgesics. He was evaluated by clinical, radiological, laboratory and scintigraphic methods, following control MRI findings suggesting infection of vertebral bodies, particularly pointing to brucellosis in addition to disc herniation. A diagnosis of psoriatic spondylitis was finally established and 7.5 mg methotrexate weekly was administered. Significant improvement was obtained of psoriatic skin lesions, low-back pain and MRI findings through a six-month treatment period.
ISSN:0770-3198
1434-9949
DOI:10.1007/BF02230367