| 英文摘要 |
A 28 year-old female suffered from chronic back pain with morning stiffness for one year. She denied any other specific associated symptoms except headache and insomnia. One of her brother had ankylosing spondylitis (AS). She had two children without abortion history. Physical examination revealed decreased Schober test yet normal chest expansion. KUB showed blurring of bilateral sacroiliac joints (A) and AS was impressed. Nevertheless, Laboratory revealed elevated erythrocyte sedimentation rate but negative HLA-B27. Accordingly, MRI T2W1 images exhibited focal marrow edema (white arrow in B and C) that could be present both in AS and osteitis condensans ilii. However the sacroiliac joints were patent without bony erosions (black arrow in B and C), osteitis condensans ilii was concluded. The patient was treated with NSAIDs, muscle relaxant, DMARDs and even low dose steroid, but the symptoms persisted. Later on, she took one dose of adalimumab injection from her brother by herself . Interestingly, the backache dramatically improved. |
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