SPINAL BONE SPECT IN CHRONIC SYMPTOMATIC ANKYLOSING-SPONDYLITIS

Bone SPECT has acquired a useful role in the evaluation of acute and c hronic back pain, Spinal pain is also a characteristic of chronic anky losing spondylitis. The authors investigated the bone SPECT appearance s of the lower thoracic and lumbar spine in 28 symptomatic patients wi th established ankylosing spondylitis, half of whom had complete ankyl osis of the sacroiliac and one third complete ankylosis of the interve rtebral joints. SPECT abnormalities were identified in 89%, Facetal jo int uptake was found in 16 (57%) patients, of whom 7 (25%) had three o r more, and 2 (7%) had seven or more active sites. The only other comm on site of uptake was in the vertebral body, in which 15 patients (54% ) showed increased uptake with three or more sites found in 3 (11%) pa tients, The authors conclude that SPECT abnormalities in the lower tho racic and lumbar spine are frequently found in patients with ankylosin g spondylitis, with the most common sites of abnormality in the faceta l joints or vertebral body, Multiple sites of uptake in the facetal jo ints maybe striking in such patients and has not been previously descr ibed.