title: Traumatic death in ankylosing spondylitis.
abstract: Ankylosing spondylitis (AS) is a chronic rheumatic disease that causes spinal rigidity with an increased risk of spinal fractures. We present a case report where a middle-aged man, in apparent good health, died following a fall from his bike. Postmortem computed tomography (CT) showed several fractures in the cervical and thoracic spine, with displacement into the spinal canal as well as spinal changes consistent with AS. The cause of death was determined to be upper spinal cord injury caused by cervical spinal fractures that were facilitated by spinal rigidity from AS. Further investigation into the medical records revealed that the decedent had previously been treated for AS. This case report illustrates the importance of obtaining a detailed medical history when investigating deaths, including nonfatal conditions, such as AS. Furthermore, it shows the value of CT in the evaluation of the mechanism and manner of death.
authors.affiliation: Department of Forensic Medicine, Aarhus University, Brendstrupgaards Vej 100, Aarhus N DK-8200, Denmark. aht@retsmedicin.au.dk
authors.forename: Asser H
authors.initials: AH
authors.lastname: Thomsen
authors.forename: Anne Grethe
authors.initials: AG
authors.lastname: Jurik
authors.forename: Lars
authors.initials: L
authors.lastname: Uhrenholt
authors.forename: Annie
authors.initials: A
authors.lastname: Vesterby
mesh_terms: D000058:Accidental Falls; D002574:Cervical Vertebrae / Q000293:injuries* / Q000473:pathology; D049429:Forensic Pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012253:Rib Fractures / Q000209:etiology / Q000473:pathology; D017565:Sarcoidosis, Pulmonary / Q000473:pathology; D016103:Spinal Fractures / Q000209:etiology* / Q000473:pathology; D013167:Spondylitis, Ankylosing / Q000150:complications* / Q000473:pathology; D013904:Thoracic Vertebrae / Q000293:injuries / Q000473:pathology; D014057:Tomography, X-Ray Computed