Case 25 A 67-year-old man with a 26-year history of AS presented to the rheumatology clinic with increased pain in his back. Four months previously he had been admitted under the general medical team after collapsing at home. A diagnosis of pulmonary embolism was made and confirmed on a computed tomography pulmonary angiogram (CTPA). The patient was discharged home on wafarin, but continued to have severe pain in his back. The pain was not alleviated by exercise, prevented sleep, and was very debilitating. There was no history of weight loss or systemic features of infection, and the patient had no prior treatment with immunosuppressive therapy. His analgesia included diclofenac 50 mg three times daily and morphine sulphate tablets 10 mg twice daily, with breakthough Oramorph as required. Examination revealed a moderate kyphosis. He was tender to palpation over T12–L3 with restricted hip movement and no evidence of peripheral synovitis. The patient was afebrile and systems examination was unremarkable, including intact neurology. His Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score was 6/10 and his spinal pain Visual Analogue Score (VAS) was 9/10 cm. Investigations showed the following: ◆ Hb 13.5 g/dL; WCC 7.7 × 10E9/L; platelets 192 × 10E9/L; creatinine 110 µ mol/L ◆ CRP 8 mg/L, ESR 4 mm/h. MRI of the spine is shown in Fig. 16.1 attached above and answer the question given in the image describe the image

Create a visual summary of AS complications including vertebral fracture