An atypical psoriatic spondylitis case, successfully treated with methotrexate

Tuzun C., Peker O., Kucuktas F., Gulbahar S., Kovanlikaya I., Fuzun S.

CLINICAL RHEUMATOLOGY, vol.15, no.4, pp.403-409, 1996 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 15 Issue: 4
  • Publication Date: 1996
  • Doi Number: 10.1007/bf02230367
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.403-409
  • Keywords: psoriatic spondylitis, lumbar disc herniation, brucella spondylitis, methotrexate, BRUCELLOSIS, SPINE, MR
  • Dokuz Eylül University Affiliated: Yes


We present a 45 - year-old male patient who was hospitalized with lumbar disc herniation and whose control magnetic resonance imaging (MRI) findings initially suggested brucella spondylitis. Definitive diagnosis, however, indicated psoriatic spondylitis and the patient was succesfully treated with methotrexate. A diagnosis of lumbar disc herniation was made in May 1991, during his psoriasis vulgaris treatment. He was hospitalized in August 1994 with a complaint of low-back pain persisting over the last six months despite treatment with analgesics. He was evaluated by clinical, radiological, laboratory and scintigraphic methods, following control MRI findings suggesting infection of vertebral bodies, particularly pointing to brucellosis in addition to disc herniation. A diagnosis of psoriatic spondylitis was finally established and 7.5 mg methotrexate weekly was administered. Significant improvement was obtained of psoriatic skin lesions, low-back pain and MRI findings through a six-month treatment period.