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J Korean Rheum Assoc. 2010 Mar;17(1):81-85. Korean. Case Report.
Sohn IW , Bang SY , Kim D , Kim TH .
Division of Rheumatology, Department of Internal Medicine, The Hospital for Rheumatic Disease, Hanyang University College of Medicine, Seoul, Korea.

Back pain is the most common symptom of ankylosing spondylitis (AS). The aggravation of back pain in AS patients is usually thought to be a flare-up of the disease activity. We report here on the case of a 31-year-old AS patient with low back pain. The lesions of this patient were unexpectedly diagnosed as metastatic spinal tumor due to cholangiocarcinoma. In a patient with AS, an acute aggravation of low back pain may be due to other pathologic conditions such as osteoporotic vertebral fracture, vertebral discitis and metastatic bone disease. Therefore, when a patient with AS presents with nonspecific low back pain, a physician should consider the above mentioned conditions.

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