Think out of the box , Man with low backache
1 min read

Think out of the box , Man with low backache

This case was contributed by 
Prof Majid Jehangir. M.D
Dept of Radiology 
GMC, Srinagar Kashmir 


A 58 year old male presented with history of low back ache  of 6 weeks duration without any history of  trauma  .He was able to do his activities of daily life ,nevertheless with difficulties due to disabling pain. 

Apart from baseline investigations  he was advised MRI spine as shown in Fig1 

MRI showed involvement of 2 adjacent vertebral body and disc with prevertebral soft tissue mimicking spinal TB

The patient was labelled as spinal TB on the basis of MRI .

ATT  was started but he had no relief  .



However, a careful observation of  MRI shows facet joint fusion at several levels  in addition to fracture through vertebro discal junction is noted at the same level as well.

Raising the possibility of Ankylosing  spondylitis with Anderson lesion.

Andersson lesion is a rare aseptic discovertebral lesion occurring in individuals with ankylosing spondylitis. It should be differentiated from infective spondylodiscitis and metastatic disease by its classical appearance on radiographs and MRI.It often requires surgical management to alleviate pain, and prevent it leading to pseudoarthrosis or kyphosis.


Fig 2

As such Plain X Ray and CT was advised which showed classic bamboo spine and Anderson lesion as shown in

Fig 3

The final diagnosis was Ankylosing spondylitis .


Further reading : Click the Link. Ankylosing Spondylitis Imaging



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