Rapid progression of destructive spondyloarthropathy.

STUDY DESIGN: A case of destructive spondyloarthropathy was reported. OBJECTIVES: To describe the rapid destruction of intervertebral disc and vertebral body as a consequence of destructive spondyloarthropathy in a patients with end-stage renal disease receiving hemodialysis. SUMMARY OF BACKGROUND DATA: An important facet of this case is that the serial radiographs provide key information about the rapid nature of dialysis associated destructive spondyloarthropathy, a condition which has been increasingly recognized over the last 2 decades. METHODS: The clinical and radiologic features of a 55-year-old dialysis patient with destructive spondyloarthropathy are herein detailed. Her serial radiographs and magnetic resonance images have implications both for our understanding of the underlying destructive process and its clinical evaluation. RESULTS: Serial lateral lumbar spines illustrated that the destructive process started at the leading edge of the endplate of vertebral body, closely followed by adjacent intervertebral disc destruction that appeared in parallel with vertebral body bone resorption. CONCLUSIONS: A case of dialysis-associated destructive spondyloarthropathy was reported, with key information about its rapid nature being provided by serial radiographs.