Combination of transverse myelitis and arachnoiditis in cauda equina syndrome of long-standing ankylosing spondylitis: MRI features and its role in clinical management.
The cauda equina syndrome (CES) is a rare neurological complication of ankylosing spondylitis (AS). Imaging diagnosis of CES in long-standing AS patients (CES-AS) using myelography, computed tomography (CT), and magnetic resonance imaging (MRI) were reported in the literature. They, however, demonstrate only the chronic abnormalities of CES-AS, i.e., dural ectasia, dorsal dural diverticula, and selective bone erosion at the posterior elements of the vertebrae. To our knowledge, imaging features of acute intradural inflammation in CES-AS were not described. We report a patient of CES-AS in whom MRI disclosed acute transverse myelitis and arachnoiditis along the lower spinal cord, and discuss the pathogenesis of CES-AS and the role of MRI in clinical management.
Lan
Howard Haw-Chang
HH
Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China. lanhc@mail.vghtc.gov.tw
Chen
Der-Yuan
DY
Chen
Clayton Chi-Chang
CC
Lan
Joung-Liang
JL
Hsieh
Chia-Wei
CW
D001100:Arachnoiditis / Q000150:complications* / Q000175:diagnosis; D015897:Comorbidity; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009187:Myelitis; D009188:Myelitis, Transverse / Q000150:complications* / Q000175:diagnosis; D011128:Polyradiculopathy / Q000150:complications* / Q000175:diagnosis; D013167:Spondylitis, Ankylosing / Q000150:complications* / Q000175:diagnosis; D013904:Thoracic Vertebrae / Q000473:pathology; D016896:Treatment Outcome