Neuropathic Spondyloarthropathy

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Neuropathic Spondyloarthropathy

The term Spondyloarthropathy means a chronic joint disease affecting vertebral column. Hanna RR et al presented a case study of a 70-year-old woman shown to a peripheral hospital with signs and symptoms of acute chronic obstructive pulmonary disease (COPD) exacerbation. Within 24 hours, the patient also reported acute on chronic onset of thoracolumbar back pain.

She refused any history of recent trauma or intravenous drug use and neither she had any long-term indwelling catheters. The patient's medical history was also muddled by stage 4 renal failure from long-standing type II diabetes, aortic stenosis, hypertension, iron deficiency anemia, and prior bariatric surgery. She never underwent dialysis before for her renal dysfunction, nor she was acquiring steroids for COPD. She was reported to be afebrile and tachypneic on clnical examination and reported subjective leg weakness; however, she was not amenable to a full neurologic examination. No localizing signs or evidence of myelopathy were observed. Perianal sensation and rectal tone were preserved. A pulmonary examination revealed the wheezes and decreased basilar air entry. The patient's white blood cell count was 6.8 × 10(9)/L, blood creatinine level was elevated to 158 mmol/L, but her blood chemistry was normal. Her erythrocyte sedimentation rate was upgraded at 56 mm/h, and her C-reactive protein level was normal at 4.4 mg/L (41.9 nmol/L). The chest radiographs depicted a mild pulmonary edema with a small right pleural effusion. The patient was shifted to another facility for assessment of findings on thoracic spine radiographs obtained at a peripheral hospital. Unenhanced thoracic spine magnetic resonance imaging (MRI) was executed first and was followed by computed tomography (CT) to further delineate the outcomes. The patient's renal status prohibited the administration of intravenous contrast material. 



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Original title of article:

Case 234: Neuropathic Spondyloarthropathy.


Hanna RR et al.

Spondyloarthropathy, Obstructive pulmonary disease, Back pain, Case report
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