Ankylosing Spondylitis
Martha Huller Maier, MD
Key Facts
Terminology
Chronic seronegative inflammatory arthropathy with predilection for axial skeleton
Imaging Findings
Spinal disease nearly always precedes lung involvement
Upper lobe severe traction bronchiectasis
Airways disease (80%)
Airway: Mosaic attenuation and air-trapping (40%)
Interstitial disease (66%)
Interstitial: Parenchymal bands (33%) most common
Mycetomas can be found in cysts or cavities
Top Differential Diagnoses
Tuberculosis
Sarcoidosis
Silicosis and Coal Worker’s Pneumoconiosis
 Axial HRCT shows the typical features of apical traction bronchiectasis  from ankylosing spondylitis. |
 Axial CECT shows subpleural fibrosis and apical capping  from ankylosing spondylitis. |
TERMINOLOGY
Abbreviations and Synonyms
Ankylosing spondylitis (AS), ankylosis deformans, Bechterew disease, Marie-Strümpell disease
Definitions
Chronic seronegative inflammatory arthropathy with predilection for axial skeleton
Extraspinal manifestations include pleuropulmonary involvement, aortitis, cardiac conduction abnormalities
IMAGING FINDINGS
General Features
Best diagnostic clue: Upper lobe severe traction bronchiectasis
CT Findings
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