Skip to main content
Top
Published in: Clinical Rheumatology 11/2007

01-11-2007 | Case Report

Combination of transverse myelitis and arachnoiditis in cauda equina syndrome of long-standing ankylosing spondylitis: MRI features and its role in clinical management

Authors: Howard Haw-Chang Lan, Der-Yuan Chen, Clayton Chi-Chang Chen, Joung-Liang Lan, Chia-Wei Hsieh

Published in: Clinical Rheumatology | Issue 11/2007

Login to get access

Abstract

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.
Literature
1.
go back to reference Shaw PJ, Allcutt DA, Bates D et al (1990) Cauda equina syndrome associated with multiple lumbar arachnoid cysts in ankylosing spondylitis: improvement following surgical therapy. J Neurol Neurosurg Psychiatry 53:1076–1079PubMed Shaw PJ, Allcutt DA, Bates D et al (1990) Cauda equina syndrome associated with multiple lumbar arachnoid cysts in ankylosing spondylitis: improvement following surgical therapy. J Neurol Neurosurg Psychiatry 53:1076–1079PubMed
2.
go back to reference Bowie EA, Glasgow GL (1961) Cauda equina lesions associated with ankylosing spondylitis: report of three cases. Br Med J 2:24–27PubMed Bowie EA, Glasgow GL (1961) Cauda equina lesions associated with ankylosing spondylitis: report of three cases. Br Med J 2:24–27PubMed
3.
go back to reference Mitchell MJ, Sartoris DJ, Moody D et al (1990) Cauda equina syndrome complicating ankylosing spondylitis. Radiology 175:521–525PubMed Mitchell MJ, Sartoris DJ, Moody D et al (1990) Cauda equina syndrome complicating ankylosing spondylitis. Radiology 175:521–525PubMed
4.
go back to reference Charlesworth CH, Savy LE, Stevens J et al (1996) MRI demonstration of arachnoiditis in cauda equina syndrome of ankylosing spondylitis. Neuroradiology 38:462–465PubMed Charlesworth CH, Savy LE, Stevens J et al (1996) MRI demonstration of arachnoiditis in cauda equina syndrome of ankylosing spondylitis. Neuroradiology 38:462–465PubMed
5.
go back to reference Westhovens R, Verstraeten A, Knockaert D et al (1994) Cauda equina syndrome complicating ankylosing spondylitis: role of computed tomography and magnetic resonance imaging. Clin Rheumatol 13:284–288PubMed Westhovens R, Verstraeten A, Knockaert D et al (1994) Cauda equina syndrome complicating ankylosing spondylitis: role of computed tomography and magnetic resonance imaging. Clin Rheumatol 13:284–288PubMed
6.
go back to reference Sant SM, O’Connell D (1995) Cauda equina syndrome in ankylosing spondylitis: a case report and review of the literature. Clin Rheumatol 14:224–226PubMedCrossRef Sant SM, O’Connell D (1995) Cauda equina syndrome in ankylosing spondylitis: a case report and review of the literature. Clin Rheumatol 14:224–226PubMedCrossRef
7.
go back to reference Rubenstein DJ, Alvarez O, Ghelman B et al (1989) Cauda equina syndrome complicating ankylosing spondylitis: MR features. J Comput Assist Tomogr 13:511–513PubMedCrossRef Rubenstein DJ, Alvarez O, Ghelman B et al (1989) Cauda equina syndrome complicating ankylosing spondylitis: MR features. J Comput Assist Tomogr 13:511–513PubMedCrossRef
8.
go back to reference Sparling MJ, Bartleson JD, Mcleod RA et al (1989) Magnetic resonance imaging of arachnoid diverticula associated with cauda equina syndrome in ankylosing spondylitis. J Rheumatol 16:1335–1337PubMed Sparling MJ, Bartleson JD, Mcleod RA et al (1989) Magnetic resonance imaging of arachnoid diverticula associated with cauda equina syndrome in ankylosing spondylitis. J Rheumatol 16:1335–1337PubMed
9.
go back to reference Oh DH, Jun JB, Kim HT et al (2001) Transverse myelitis in a patient with long-standing ankylosing spondylitis. Clin Exp Rheumatol 19:195–196PubMed Oh DH, Jun JB, Kim HT et al (2001) Transverse myelitis in a patient with long-standing ankylosing spondylitis. Clin Exp Rheumatol 19:195–196PubMed
10.
go back to reference Matthews WB (1968) The neurological complications of ankylosing spondylitis. J Neurol Sci 6:561–573PubMedCrossRef Matthews WB (1968) The neurological complications of ankylosing spondylitis. J Neurol Sci 6:561–573PubMedCrossRef
11.
go back to reference Lee MLH, Waters DJ (1962) Neurological complication of ankylosing spondylitis. Br Med J 1:798CrossRef Lee MLH, Waters DJ (1962) Neurological complication of ankylosing spondylitis. Br Med J 1:798CrossRef
12.
go back to reference Confavreux C, Larbre JP, Lejeune E et al (1991) Cerebrospinal fluid dynamics in the tardive cauda equina syndrome of ankylosing spondylitis. Ann Neurol 29:221–223PubMedCrossRef Confavreux C, Larbre JP, Lejeune E et al (1991) Cerebrospinal fluid dynamics in the tardive cauda equina syndrome of ankylosing spondylitis. Ann Neurol 29:221–223PubMedCrossRef
13.
go back to reference Rubenstein DJ, Ghelman B (1988) Case report 477: cauda equina syndrome (CES) complicating long-standing ankylosing spondylitis (AS). Skeletal Radiol 17:212–215PubMedCrossRef Rubenstein DJ, Ghelman B (1988) Case report 477: cauda equina syndrome (CES) complicating long-standing ankylosing spondylitis (AS). Skeletal Radiol 17:212–215PubMedCrossRef
14.
go back to reference Bilgen IG, Yunten N, Ustun EE et al (1999) Adhesive arachnoiditis causing cauda equina syndrome in ankylosing spondylitis: CT and MRI demonstration of dural calcification and a dorsal dural diverticulum. Neuroradiology 41:508–511PubMedCrossRef Bilgen IG, Yunten N, Ustun EE et al (1999) Adhesive arachnoiditis causing cauda equina syndrome in ankylosing spondylitis: CT and MRI demonstration of dural calcification and a dorsal dural diverticulum. Neuroradiology 41:508–511PubMedCrossRef
15.
go back to reference Larner AJ, Pall HS, Hockley AD (1996) Arrested progression of cauda equina syndrome of ankylosing spondylitis after lumboperitoneal shunting. J Neurol Neurosurg Psychiatry 61:115–116PubMed Larner AJ, Pall HS, Hockley AD (1996) Arrested progression of cauda equina syndrome of ankylosing spondylitis after lumboperitoneal shunting. J Neurol Neurosurg Psychiatry 61:115–116PubMed
Metadata
Title
Combination of transverse myelitis and arachnoiditis in cauda equina syndrome of long-standing ankylosing spondylitis: MRI features and its role in clinical management
Authors
Howard Haw-Chang Lan
Der-Yuan Chen
Clayton Chi-Chang Chen
Joung-Liang Lan
Chia-Wei Hsieh
Publication date
01-11-2007
Publisher
Springer-Verlag
Published in
Clinical Rheumatology / Issue 11/2007
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-007-0593-2

Other articles of this Issue 11/2007

Clinical Rheumatology 11/2007 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.