Super-acute aseptic spondylitis as the first manifestation of round calcifying nucleopathy in a 77-year-old man. A case report.

Abstract

This is a report of an unusual case of very late onset, symptomatic, round calcifying nucleopathy. To describe this unusual case of calcifying nucleopathy in a 77-year-old man who had no previous back problems, but had a history of diffuse skeletal hyperostosis. The resorption of calcifying nucleopathy associated with reactional spondylitis is a classic occurrence in children but is rare in adults. Spondylitis was diagnosed on the basis of pain, a transient Babinski's sign, and systemic inflammation. Radiographs, a bone scan, and magnetic resonance imaging revealed a large calcified nucleopathy of the T12-L1 disc associated with spondylitis of T12. The calcification disappeared within 3 weeks, and recovery was clinically and biologically complete after treatment consisting of only rest and analgesics. A diagnosis of resorption of a round calcifying nucleopathy is not to be excluded in the elderly patient. This event can mimic an infectious spondylitis clinically and biologically.