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Pulmonary fibrosis in ankylosing spondylitis

Case contributed by Dr Jan Frank Gerstenmaier


This patient attends medical outpatient clinics in two specialties.

Patient Data

Age: 65 years old
Gender: Male

Chest radiograph

There is bilateral volume loss due to pulmonary fibrosis with an upper zone predilection.

CT demonstrates upper and mid zone fibrosis bilaterally with extensive bullous change. Syndesmophytes and vertebral body squaring are shown in the thoracic spine. There is some kyphosis.

Case Discussion

As little as 1% of ankylosing spondylitis patients have upper zone fibrosis on chest radiographs. The natural radiographic history is that of reticulonodular opacities becoming confluent. Bullae and cavitation is typical as in this case, therefore mimicking tuberculosis.

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Case information

rID: 24687
Published: 5th Sep 2013
Last edited: 8th Aug 2020
Inclusion in quiz mode: Included

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