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 the HLAB27 antigen in the serum was also noted. On the coronal plane (T2wi/fat sat/STIR sequence), we can see hyperintense lesions in the corners of vertebral endplates. This is due to bone marrow edema – Romanus lesions (shiny mark in the corner). Thickening hyperintensity on T2wi/fat sat/STIR 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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