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Ankylosing spondylitis - calcified sacrotuberous ligament

Case contributed by Praveen Jha
Diagnosis almost certain

Presentation

Chronic back, hip, and perineal pain. HLA-B27 positive. Previous diagnosis of ankylosing spondylitis.

Patient Data

Age: 60 years
Gender: Male
  • sclerosed bilateral sacroiliac joints
  • pencil-like calcifications extending from sacrum to ischial tuberosities, suggesting sacrotuberous ligament calcification
  • bilateral hip arthropathy

Case Discussion

One of the significant complications, apart from sacroiliitis, in cases of ankylosing spondylitis is the calcification of sacrotuberous and sacrospinous ligaments. This can cause pudendal canal entrapment, resulting in chronic perineal pain. It is important to recognize and mention this finding if demonstrated.

Case courtesy: Dr. Abhijit Yadav, Dr. BL Yadav Imaging and Research Center, Satna.

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