CTICasesRestrictive Lung Abnormality due to Ankylosing Spondylitis
Imaging findings
Chest radiographs showed clear lungs with no pleural thickening or parenchymal disease, though subtle spinal kyphosis was noted. CT revealed significant fusion of the rib articulations with the transverse processes and rib heads along the thoracic spine, with sagittal reformats confirming ankylosis at the facet joints.
Key takeaways
Restrictive lung disease is not always caused by intrinsic lung pathology; here the restriction stemmed from the chest wall's inability to expand due to spinal and rib-articulation fusion from ankylosing spondylitis. When evaluating a restrictive pattern on pulmonary function tests, clinicians should consider chest wall abnormalities like kyphosis or ankylosis alongside more common causes such as neuromuscular weakness or interstitial lung disease. Apical fibrosis is a described but rare manifestation of ankylosing spondylitis, and was not present in this patient.
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