Ankylosing spondylitis (AS) and diffuse idiopathic skeletal hyperostosis (DISH) are conditions that can cause bony ankylosis throughout the spinal column. This bony fusion can cause the spine to become rigid and susceptible to fracture, even with minor trauma. Accurate and rapid diagnosis is of critical importance in the setting of trauma and some acute injuries may be difficult to recognize on initial imaging. A more thorough understanding of findings in this situation is necessary to avoid delayed or missed diagnosis and to guide treatment.
Educational Goals / Teaching Points
By reviewing specific cases, this educational exhibit will provide a review of trauma involving patients with ankylosed spines and will discuss imaging findings, fracture patterns, and specific imaging pearls and pitfalls to aid the radiologist in accurate imaging interpretation.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This case-based exhibit depicts traumatic spinal injury in patients with AS and DISH using images from multiple modalities including CT andMRI. This presentation will demonstrate both conspicuous and subtle findings involving traumatic injury of the rigid spine to help the radiologist confidently identify these abnormalities.
Even minor trauma to the rigid, fused spinal column can cause severe damage. In the setting of a rigid spine, some acute injuries may be unrecognized on initial imaging and lead to delayed treatment and poor outcomes. By understanding the imaging features in spinal ankylosis, delayed or missed findings can be avoided.