Andersson and Romanus lesions

Case contributed by Dr Ammar Haouimi

Presentation

Chronic low back pain. Known inflammatory spondyloarthropathy.

Patient Data

Age: 35 years
Gender: Male
MRI

The MRI sequences demonstrate:

  • hemispherical shape lesions involving the central portion of both vertebral halves and discs mainly of T10-T11, T11-T12, and L1-L2; they elicit high signal on T2/STIR and a low signal on T1 and with enhancement on postcontrast sequences in keeping with Andersson lesions

  • lesions of the anterior vertebral edges of L1 and L3 eliciting a low signal on T1, high signal on T2 and STIR with enhancement in keeping with active Romanus lesions 

Case Discussion

Active Romanus and Andersson lesions in a patient with ankylosing spondylitis.

Andersson lesion, also known as rheumatic spondylodiscitis, is defined as an inflammatory non-infectious condition involving the intervertebral discs by spondyloarthritis. It occurs in about 8% of patients with ankylosing spondylitis.

Romanus lesion is considered as an early finding in inflammatory spondyloarthropathies, such as ankylosing spondylitis and enteropathic arthritis, seen as irregularity and erosion involving the anterior and posterior edges of the vertebral endplates.

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