Paget-like ankylosis of the sacroiliac joint

Case contributed by Roberto Schubert
Diagnosis almost certain

Presentation

Chronic low back pain.

Patient Data

Age: 55 years
Gender: Male

Predominantly translucent architectural bone distortion with coarsened trabeculae in the 2nd lumbar vertebra, the os sacrum and the right os ilium consistent with Paget disease. Massive osteoarthritis and cam deformity of the right hip. Complete ankylosis of the right sacroliac joint. No signs of prior inflammation on the left. Deformity of L2.

Nuclear medicine

Marked tracer uptake, but not in all affected regions shown by CT, suggesting quiescent areas in Paget disease of the bone.

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