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[Sacroiliac changes, HLA-B27 negative, in primary hyperparathyroidism and osteomalacia]
Schweizerische Medizinische Wochenschrift
|July 14, 1979
Summary
Radiological sacroiliac changes mimicking ankylosing spondylitis were observed in patients with metabolic bone diseases like osteomalacia and primary hyperparathyroidism. Investigating these conditions is crucial for HLA B 27 negative cases.
Area of Science:
- Rheumatology
- Endocrinology
- Radiology
Background:
- Radiological sacroiliac (SI) changes can mimic inflammatory arthropathies.
- Metabolic bone diseases are not typically associated with SI joint involvement.
Observation:
- Three female patients presented with radiological SI changes.
- Two patients had primary hyperparathyroidism, one with chondrocalcinosis; one had osteomalacia secondary to celiac disease.
- None had a history suggestive of spondyloarthritis or renal impairment.
Findings:
- SI lesions were attributed to subchondral bone changes from metabolic bone disease.
- Osteomalacia showed right-sided SI lesions and a Looser's zone, suggesting pseudofractures as a cause.
- Improvement in low back pain and stiffness occurred after vitamin D treatment in the osteomalacia case.
Implications:
- Metabolic bone diseases should be considered in the differential diagnosis of HLA B 27 negative radiological sacroiliitis.
- These findings highlight the potential for metabolic bone disorders to manifest with SI joint changes, mimicking inflammatory conditions.
- Further investigation into the link between metabolic bone diseases and SI joint pathology is warranted.