Abstract
Early Spondyloarthritis Presenting as Premenopausal Osteoporosis and Multiple Vertebral Fractures: A Case Report
Highlights
Inflammatory arthritis including Rheumatoid Arthritis (RA) and Ankylosing Spondylitis (AS) are established risk factors for early osteoporosis [1,2]
We report a 30-year-old woman who presented during pregnancy with mechanical type backache due to non-traumatic multiple vertebral fractures
The rheumatoid factor and HLA B27 were negative. She was successfully managed with NSAIDS, zolindronic acid and calcium supplementation. This is an example of early inflammatory arthritis in the background of multiple risk factors causing osteoporosis severe enough to cause fragility fractures
Summary
Inflammatory arthritis including Rheumatoid Arthritis (RA) and Ankylosing Spondylitis (AS) are established risk factors for early osteoporosis [1,2]. A 30-year-old lady, 2 weeks after the delivery of her second child presented with non-traumatic vertebral wedge fractures at multiple levels She was referred to the medical ward for further investigations. On further inquiry into risk factors for osteoporosis, she revealed that she had childhood asthma and was given systemic steroids frequently She took oral and inhalational preparations on and off from 8 years to 16 years of age. Contrast Enhanced Computer Tomography (CECT) of the spine showed osteopenia and multiple stable wedge fractures in the vertebral bodies at multiple levels (T8-T11) and erosions of the sacroiliac (SI) joints. This was compatible with chronic erosive sacroilitis. Further investigations to exclude secondary inflammatory conditions and chronic infections were negative (Table 2)
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