Andersson lesion in ankylosing spondylitis

A middle-aged male patient developed acute back pain and a lumbar vertebral lesion following trivial physical trauma. The lesion was considered as tuberculous on vertebral x-rays and MRI. After biopsy of the lesion and spinal fixation, the patient was kept on empirical antituberculous treatment (ATT...

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Bibliographic Details
Published in:BMJ case reports 2013-04, Vol.2013, p.bcr2012008404
Main Authors: Dhakad, Urmila, Das, Siddharth K
Format: Article
Language:English
Subjects:
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Antirheumatic Agents - therapeutic use
Asia
Back Pain - diagnosis
Back Pain - drug therapy
Bed Rest
Biopsy
Diagnosis, Differential
Folic Acid - therapeutic use
Humans
Indian Sub-Continent
Lumbar Vertebrae - pathology
Magnetic Resonance Imaging
Male
Methotrexate - therapeutic use
Methylprednisolone - therapeutic use
Middle Aged
Pain
Reminder of Important Clinical Lesson
Spondylitis, Ankylosing - diagnosis
Spondylitis, Ankylosing - drug therapy
Steroids - therapeutic use
Sulfasalazine - therapeutic use
Tuberculosis
Vertebrae
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Summary:A middle-aged male patient developed acute back pain and a lumbar vertebral lesion following trivial physical trauma. The lesion was considered as tuberculous on vertebral x-rays and MRI. After biopsy of the lesion and spinal fixation, the patient was kept on empirical antituberculous treatment (ATT) to which he did not respond. On re-evaluation he was diagnosed to have an Andersson lesion in ankylosing spondylitis (AS). ATT was stopped and he was successfully managed by rest, steroids, methotrexate and sulfasalazine. A careful look at the patient’s plain x-ray spine and awareness about the lesion can avoid misdiagnosis of this characteristic vertebral lesion found in AS.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2012-008404