Case 37 of the ASAS Online Case Library // Demonstration by Denis Poddubnyy and Kay G. Hermann

A 60-year-old patient recovered from Guillain-Barré syndrome three years ago and now complains of back pain. Find out more about his clinical symptoms and the imaging findings.

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https://cases.asas-group.org/494763.html

In brief, this is a case of axial spondyloarthritis.

Despite the atypical age for an axial SpA onset above the age of 45 years and the unusual MRI presentation of inflammation affecting predominantly entheseal compartment of the sacroiliac joints, we assumed an immune-mediated process consistent with axial spondyloarthritis (axial SpA) associated with HLA-B27. The severe viral infection experienced may have played a triggering role in this case.

After switching from Ibuprofen to Etoricoxib, the patient responded well, with the BASDAI decreasing from 6.2 to 0.8 and ASDAS from 3.2 to 0.9. The patient was doing well in the following 6 months. The follow-up examination after 6 months demonstrated substantial improvement of inflammation.

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#spondyloarthritis #elearning #sacroiliacjoint #reactivearthritis