Presentation
Bowel obstruction?
Patient Data

Unremarkable bowel gas pattern.
Complete ankylosis of both sacroiliac joints.
Case Discussion
How much notice do you take of the rest of the radiograph when reporting abdominal radiographs for bowel obstruction?
You might strike it lucky and find something else interesting and it also notches up a few brownie points if you spot other pathology.
In this case, the sacroiliac joints are completely ankylosed. This is usually due to a seronegative spondylarthropathy. No evidence of ankylosing spondylosis in the lumbar spine.
This would make a decent rapid report radiograph for the FRCR 2B rapids or similar fellowship examination.