A 32 years old male patient, with chronic back pain. 3 months prior to the MRI scan, the pain intensified, combined with fever and inability to stay in a supine position. The presence of HLAB27 antigen in the serum was also noted. On the sagittal plane (T1wi sequence), we can see hypointense lesions in the anterior/posterior corners of vertebral endplates. This is due to bone marrow edema – Romanus lesions. Thickening hypointensity on T1wi sequence of the anterior longitudinal ligament, with some edema of surrounding fat (reactive enthesopathy/enthesitis), can also be seen on this MRI scan. This phenomenon is known as Bechterew disease or Marie Strumpell disease.
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