Chalkstick fracture in ankylosing spondylitis

Case contributed by Dr Vikas Shah

Presentation

Background of ankylosing spondylitis. Severe pain in back following a light fall.

Patient Data

Gender: Male
X-ray

Lumbar spine x-ray

Both views show classic signs of ankylosing spondylitis:

  • dagger spine sign of continuous ossification of the interspinous and supraspinous ligaments
  • squared vertebral bodies
  • bamboo spine sign due to continuous syndesmophytes
  • fused sacroiliac joints

The dagger is broken on the AP view indicating a fracture at this location. The lateral view confirms this.

The CT confirms a three-column fracture at L3 level and the other signs of ankylosing spondylitis.

Case Discussion

These fractures are known as "chalkstick" fractures because of how brittle the spine becomes in ankylosing spondylitis, and can occur with minimal trauma. They usually occur at the cervicothoracic or thoracolumbar junctions.

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Case information

rID: 40471
Case created: 22nd Oct 2015
Last edited: 20th Dec 2015
Inclusion in quiz mode: Included

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