A novel pattern of abnormal spinal uptake on Tc-99m MDP skeletal scintigraphy in ankylosing spondylitis

A 38-year-old man had neck stiffness with markedly diminished rotation that had developed progressively during a period of 8 years. No features of systemic illness were apparent. A clinical diagnosis of ankylosing spondylitis was made. However, HLA-B27 was not detected. Findings of plain radiographs were normal, and computed tomography showed only minor degenerative changes in the facet joints. Three-phase bone scintigraphy revealed hyperemia in most of the cervical spine and thoracic costovertebral junctions and corresponding increased delayed bony uptake in cervical joints and all the costovertebral junctions extending onto the ribs.