Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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December 31, 2007
Ankylosing Spondylitis + Acute Fracture
- Prevalence of AS is 1-3/1000.
- HLA-B27 is present in about 90% of patients.
- Acute cervical and thoracic fractures generally involve discs and adjacent vertebrae and ligaments (tend to involve all 3 columns and thus are very unstable).
- Fractures may be difficult to identify on radiographs due to osteopenia, and MRI is recommended (nearly 17% of patients may have neurological deterioration due to delayed diagnosis).
- Spinal complications of AS include: fractures, epidural hematomas, cauda equina syndrome, erosive arachnoiditis, atlantoaxial subluxation, myelopathy, kyphosis, pseudoarthrosis mimicking discitis.