How are fractures screened for in patients with ankylosing spondylitis (AS) and undifferentiated spondyloarthropathy (USpA)?

Updated: Jul 17, 2018
  • Author: Lawrence H Brent, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Proper diagnosis of a vertebral fracture is often delayed because the patient does not realize the need to seek medical help, because the physician fails to consider the possibility of a vertebral fracture after minor trauma, or because the fracture is difficult to visualize on radiography.

In some cases, radiographic diagnosis is made difficult by the presence of osteopenia and spinal deformity. Additionally, immobility of the glenohumeral joint can interfere with the ability to obtain an adequate “swimmer’s view” to visualize the lower cervical spine. In many cases, CT scans are required for assessment of the spine. The possibility of fractures in the transverse plane suggests the need for sagittal reformatting of the images. If visualization is still inadequate, MRI and bone scans may be helpful.


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