CTICasesAnkylosing Spondylitis with Juxtaphrenic Peak
Imaging findings
Chest radiograph shows apical lung scarring and a left-sided juxtaphrenic peak. The patient has a history of ankylosing spondylitis. The juxtaphrenic peak is shown on CT to result from traction on an inferior accessory fissure.
Key takeaways
Ankylosing spondylitis can rarely cause upper lobe fibrobullous disease and apical scarring. Associated lung volume loss can cause a juxtaphrenic peak, which is caused by diaphragmatic traction on an inferior accessory fissure rather than the pulmonary ligament.
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