A parrot’s beak in the lumbar spine

This computed tomography (CT) scan shows the spine of a man in his 50s who presented to hospital with low back pain and limited mobility of the lumbar spine for four months (fig 1). Lumbar radiographs showed worm eaten bone destruction with sclerosis of the peripheral bone. The CT scan showed anterior osteophytes (small hook shaped bone growths, shaped like a parrot’s beak, around the intervertebral disc, “parrot’s beak sign”) (arrow). A brucellosis antibody test showed positive results in the tiger red plate agglutination test and tube agglutination test (titre, 1:400), confirming a diagnosis of brucella spondylitis.bmj;384/mar14_4/e078949/F1F1f1Fig 1Brucella spondylitis is a complication of spinal arthritis caused by brucellosis infection.12 Risk factors for brucellosis include living in or travelling to endemic countries, consumption of unpasteurised dairy products or raw meat products, occupational exposure, and hunting. Despite four months of regular anti-brucellosis treatment, the patient’s lower back pain and intermittent claudication worsened,…
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