VATER association: is it recognised by rheumatologists?
The authors describe an adult patient with history of chronic low back pain and recurrent prostatitis, marked limitation of lumbar spine motion and a radiograph demonstrating fused lumbar vertebrae, which suggest a diagnosis of spondylarthropathy. However, the absence of radiographic evidence of sacroilitis, the nature of the vertebral defects and a history of imperforate anus pointed towards the diagnosis of VATER association, rather than a spondylarthropathy. Although most patients with VATER association are diagnosed during infancy, the musculoskeletal anomalies can be overlooked while the potentially life-threatening problems are under treatment. These anomalies may become evident later in life. Therefore, in a rheumatologic practice, when evaluating patients with back pain and vertebral anomalies, one should become familiar with the varied manifestations of VATER association.
Erkan
D
D
Division of Rheumatology, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York, USA. derkan@pol.net
Lam
L A
LA
Yazici
Y
Y
Magid
S K
SK
D000015:Abnormalities, Multiple / Q000175:diagnosis*; D000328:Adult; D001006:Anus, Imperforate / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000209:etiology; D008159:Lumbar Vertebrae / Q000002:abnormalities / Q000000981:diagnostic imaging; D008297:Male; D011859:Radiography; D013167:Spondylitis, Ankylosing / Q000175:diagnosis*; D013577:Syndrome; D021801:Zygapophyseal Joint / Q000002:abnormalities