Abstract

The case of an 88-year-old is described who presented with complete heart block, immobility and anaemia. The CT demonstrated gross atrophy of the posterior paraspinal muscles and spinal fusion. A diagnosis of ankylosing spondylitis was made and he was subsequently treated by insertion of a permanent pacemaker. Up to one quarter of patients with ankylosing spondylitis develop a cardiac rhythm disturbance due to fibrosis of the conductive system. The causes of paraspinal muscular atrophy are discussed as well as the importance of reviewing all the information available on a CT and of evaluating multiplanar imaging.

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