AXIAL SKELETAL CHANGES IN PARALYZED PATIENTS MAY MIMIC ANKYLOSING-SPONDYLITIS

Patients with paralysis may develop radiographic changes in the axial skeleton and sacroiliac joints that resemble those seen in ankylosing spondylitis. These similarities can result in confusion when evaluatin g paralysed patients with back pain. We report on a patient with paral ysis secondary to amyotrophic lateral sclerosis who developed back pai n, apparent sacroiliac joint fusion, and a 'bamboo spine', leading to the misdiagnosis of ankylosing spondylitis. Serial radiographs of the bony changes in our patient are presented, along with a brief review o f the literature on axial skeletal abnormalities in paralysis and a di scussion of the subtle changes that distinguish immobilization spondyl oarthropathy from ankylosing spondylitis.