Hip joint involvement in ankylosing spondylitis

Case contributed by Dr Charlie Chia-Tsong Hsu

Presentation

Hip pain.

Patient Data

Age: 35
Gender: Male
Modality: X-ray

Evidence of concentric narrowing of the hip joints, femoral osteophytosis and subchondral sclerosis. The hip joints are asymmetrically affected, greater on the right. There is ossification of the ligamentous origins in particular at the ischial tuberosities giving a furry appearance. Near complete fusion of the sacroiliac joints with erosive changes at the pubic symphysis.  

Modality: X-ray

Syndesmophytes are present with "squaring" of the thoracolumbar spine and fusion of the mid lumbar vetebrae. 

1. Sagittal and 2. coronal CT images shows syndesmophytes in the outer fiber of annulus fibrosis and osteitis at the anterior corners of the vertebral bodies. The bone is osteopenic with long column fusion of vertebral bodies and facet joints with skipped intervening regions. 
3. Axial CT images shows erosive change in the sternocalvicular joint. 

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Case Information

rID: 19267
Case created: 21st Aug 2012
Last edited: 27th May 2016
Inclusion in quiz mode: Included

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