Radiographic Findings and Differential Diagnosis
Click images to review films and listen to further audio discussion by Dr. Stephen Fridinger.
LUMBAR SPINE: Among other postural alterations note
the diminished lumbar lordosis. There are thin linear opacities
of the anterior portion the disc margin representing marginal
syndesmophytes, ossification of the outer annulus, throughout
the lumbar spine with the exception of L5-S1. On the frontal
film, these syndesmophytes produce a so called "bamboo spine".
The facet joints appear to be ankylosed, bilaterally, throughout
the entire lumbar spine with the exception of L5-S1. The sacroiliac
joints are fused bilaterally, with osseous fusion of the upper
portion of the joints creating "star signs." Ankylosis of
the costovertebral joints at T12, bilaterally, is also noted.
Note the calcification of the abdominal aorta and common iliac
For the differential diagnosis in this case, the following
may be considered:
1. Diffuse Idiopathic Skeletal Hyperostosis (DISH)
2. Psoriatic Arthritis
3. Ankylosing Spondylitis
4. Reiter's Disease
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Introduction to Unknown Cases
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