Ankylosing spondylitis

Case contributed by Dr Heba Abdelmonem


Low back pain

Patient Data

Age: 49 years
Gender: Male

Abnormal sclerosis as well as erosion of the anterior corner of L3, L4 and L5 superior end plates Shiny corner sign (ankylosing spondylitis) associated with bilateral irregularities and subchondral sclerosis of the sacroiliac joints.

Case Discussion

Adult male with long history of lowback pain. Ct of the spine demonstrates abnormal sclerosis as well as erosion of the vertebral superior end plates referred as Shiny corner sign,known as a Romanus lesion, which is considered an early sign of inflammatory spondyloarthropathies as ankylosing spondylitis.

On MRI the 'shiny corners' appear as foci of high T1 signal due to focal fatty marrow as a result of chronic inflammation. MRI however can easily detect these changes before plain radiography as initial increased signal on T2 and STIR with decreased signal on T1WI. 

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Case information

rID: 52728
Published: 20th Apr 2017
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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