Cerebral magnetic resonance imaging in a patient with ankylosing spondylitis and multiple sclerosis-like syndrome

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Published on: February 19, 2021

M Cellerini1, S Gabbrielli, S M Bongi

  • 1Neuroradiology Unit, Trauma Center (CTO), Careggi Hospital, Florence, Italy. giordanog@a-ocareggi.toscana.it

Neuroradiology
|January 17, 2002
PubMed

Insights

Ankylosing spondylitis (AS) may present with symptoms mimicking multiple sclerosis (MS). Cerebral MRI findings in a patient with AS suggested the coexistence of MS, highlighting the need for careful differential diagnosis.

Area of Science:

  • Neurology
  • Radiology
  • Rheumatology

Background:

  • Ankylosing spondylitis (AS) is a chronic inflammatory disease primarily affecting the spine.
  • Multiple sclerosis (MS) is a demyelinating disease of the central nervous system.
  • Co-occurrence of AS and MS is rare, posing diagnostic challenges.

Observation:

  • A patient presented with clinical and cerebral magnetic resonance imaging (MRI) findings.
  • Cerebral MRI revealed multiple, scattered lesions with signal abnormalities, characteristic of MS.
  • One lesion demonstrated contrast enhancement, suggesting active inflammation.

Findings:

  • The observed MS-like lesions on cerebral MRI in a patient with AS raised suspicion for concurrent MS.
  • The pattern of lesion dissemination in space and time is a key diagnostic criterion for MS.
  • Enhanced MRI findings supported the possibility of coexisting AS and MS.

Implications:

  • This case underscores the importance of considering MS in patients with AS presenting with neurological symptoms.
  • Cerebral MRI is crucial for differentiating MS-like syndromes from actual MS in AS patients.
  • Further investigation may be warranted to understand the potential link between AS and MS pathogenesis.

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