Late-onset spondyloarthropathy mimicking reflex sympathetic dystrophy syndrome⋄<fn id="FN1"><no>1</no>Pour citer cet article, utiliser ce titre en anglais, re´fe´rence parue dans Joint Bone Spine, 2003, vol. 70.</fn>

Atypical presentations are common when spondyloarthropathy develops in older patients. We report 2 cases initially mistaken for Reflex Sympathetic Dystrophy Syndrome (RSDS). Both patients were men, aged 62 and 75 years, respectively, with marked painful edema of a foot. One patient reported a moderate-energy trauma as the triggering event. Severe diffuse demineralization was noted on radiographs and diffuse hyperactivity on bone scans starting at the early vascular phase. These findings suggestive of RSDS led to treatment with calcitonin, griseofulvin and pamidronate, all of which were ineffective. Laboratory tests showed severe inflammation, promoting investigations for other conditions. Spondyloarthropathy was diagnosed based on oligoarthritis with sacroiliitis, presence of HLA B27 and a favorable response to nonsteroidal antiinflammatory therapy. In older patients, edema of the foot with severe demineralization and laboratory evidence of inflammation should suggest a spondyloarthropathy. [Copyright &y& Elsevier]