CASE REPORT article
Front. Musculoskelet. Disord.
Sec. Systemic Inflammatory Joint Diseases
Volume 3 - 2025 | doi: 10.3389/fmscd.2025.1575740
Aseptic spondylodiscitis revealing non-radiographic axial spondyloarthritis associated with Crohn's disease
Provisionally accepted
- Hospital University Tahar Sfar, Mahdia, Tunisia
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Aseptic spondylodiscitis (SD) is a rare complication of axial spondyloarthritis (AS) that can develop during the course of the disease, often asymptomatically. Magnetic resonance imaging (MRI) is the gold standard for diagnosing SD, but due to its rarity, the condition is frequently misdiagnosed.We report the case of a 60-year-old male who presented with back pain and elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels. MRI of the dorsolumbar spine revealed SD from the D6 to D8 vertebrae. An infectious workup was negative. During hospitalization, the patient developed acute abdominal pain, cessation of bowel movements, and gas retention. Abdominal CT revealed ileitis, prompting a colonoscopy, which confirmed Crohn’s disease (CD) through histopathological analysis. Pelvic MRI also showed sacroiliitis. The diagnosis of aseptic SD revealing non-radiographic AS associated with CD was made according to the ASAS 2009 criteria, and the patient was treated with sulfasalazine, showing favorable improvement.Only a few cases of SD in patients with AS and inflammatory bowel disease (IBD) have been reported. This case underscores that SD can be the initial clinical manifestation of non-radiographic AS associated with CD. Although challenging to recognize, this condition may present with unpredictable and varied clinical symptoms, requiring a comprehensive diagnostic approach.
Keywords: Aseptic spondylodiscitis, Non-radiographic axial spondyloarthritis, Back Pain, Crohn's disease, Andersson lesion
Received: 12 Feb 2025; Accepted: 05 Jun 2025.
Copyright: © 2025 Jomaa, Abid, Brahem, Neifar, Ardhaoui, Sarraj and Younes. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Olfa Jomaa, Hospital University Tahar Sfar, Mahdia, Tunisia
Hayfa Abid, Hospital University Tahar Sfar, Mahdia, Tunisia
Olfa Neifar, Hospital University Tahar Sfar, Mahdia, Tunisia
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