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Journal articles on the topic 'Ankylosis spondylitis'

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Published: 9 March 2023
Last updated: 10 March 2023

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1

Roth, RD. "Tarsal ankylosis in juvenile ankylosing spondylitis." Journal of the American Podiatric Medical Association 76, no. 9 (September 1, 1986): 514–18. http://dx.doi.org/10.7547/87507315-76-9-514.

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2

Haroon, Nigil. "Ankylosis in ankylosing spondylitis: current concepts." Clinical Rheumatology 34, no. 6 (May 3, 2015): 1003–7. http://dx.doi.org/10.1007/s10067-015-2956-4.

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3

Reinders, Antoinette, and Matthys J. Van Wyk. "Bamboo spine – X-ray findings of ankylosing spondylitis revisited." South African Journal of Radiology 16, no. 3 (September 10, 2012): 111–13. http://dx.doi.org/10.4102/sajr.v16i3.294.

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Ankylosing spondylitis is a debilitating disease that is one of the seronegative spondylarthropathies, affecting more males than females in the proportion of about 6:1 in the age group 15 - 35 years of age. Early radiographic findings include bilateral sacro-iliitis and early axial (lower lumbar spine) ankylosis. Typical X-ray findings are florid spondylitis (Romanus lesions), florid diskitis (Andersson lesions), early axial ankylosis, enthesitis, syndesmophytes and insufficiency fractures. Typical radiological abnormalities are pointed out on conventional X-rays and reviewed for early diagnosis and prompt treatment of patients at risk.
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4

Felstead, Andrew M., and Peter J. Revington. "Surgical Management of Temporomandibular Joint Ankylosis in Ankylosing Spondylitis." International Journal of Rheumatology 2011 (2011): 1–5. http://dx.doi.org/10.1155/2011/854167.

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Relatively few patients develop such severe degenerative temporomandibular joint (TMJ) disease that they require total joint replacement. Current indications include those conditions involving condylar bone loss such as degenerative (osteoarthritis) or inflammatory joint disease (ankylosing spondylitis, rheumatoid, and psoriatic). Ankylosis of the temporomandibular joint (TMJ) secondary to ankylosing spondylitis remains an under investigated entity. We aim to provide an overview of treatment objectives, surgical procedures, and our experience with total TMJ replacement for this condition.
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5

Khudaverdyan, Anahit Yu, Seda H. Devejyan, Ruben H. Davtyan, Azat A. Yengibaryan, Arshak A. Hovhanesyan, and Shota A. Vardanyan. "Female with Ankylosing Spondylitis from the 7th–6th century BCE Lori Berd burial (Armenia)." Anthropological Review 84, no. 1 (March 1, 2021): 85–100. http://dx.doi.org/10.2478/anre-2021-0005.

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Abstract A female skeleton from the Lori Berd archaeological cemetery, located near the city of Stepanavan (Lori Province of Armenia) is described. Palaeopathological analysis revealed a variety pathology (ankylosis of the sacroiliac joints, ankylosis of the vertebrae, syndesmophytes, ankylosed of the costovertebral and costotransverse joint fusions, kyphosis, lordosis, fracture of the anterior inferior iliac spine and traumatic lesions). This paper reports a new case of ankylosing spondylitis in a skeleton and a differential diagnosis performed to determine the etiology of the condition. The vertebral bodies remodel and together with the associated syndesmophytes form a continuous, smooth bone surface that is sometimes referred to as “bamboo spine”. In this skeleton changes in the spine, ribs, the sacrum, acetabulum, head of the femur and greater trochanter, as well as the anterior inferior iliac spine are typical of ankylosing spondylitis in advanced stage. Addtionally, there were signs of a traumatic death with injuries sustained to the scapula and vertebra. Using osteological markers in combination with the reconstruction of the archaeological context, the burial pattern suggests that the pathology the female suffered was likely due to her physical deficiencies.
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6

Xu, Bo, Fuqin Bao, Juan Ma, and Zhiqi Li. "Comparative Analysis of Computed Tomography and Magnetic Resonance Imaging in Clinically Examining Sacroiliac Joint Complications of Ankylosing Spondylitis." Journal of Medical Imaging and Health Informatics 10, no. 12 (December 1, 2020): 2940–43. http://dx.doi.org/10.1166/jmihi.2020.3236.

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Background: To analyze computed tomography (CT) and magnetic resonance Imaging (MRI) in examination diagnosis of sacroiliac joint disease of ankylosing spondylitis. Methods: Eighty patients with ankylosing spondylitis were randomly selected our experimental subjects, and CT and MRI examinations were performed on them to observe and analyze the diagnosis results of the two examination methods. Results: The detection rates of I and II for ankylosing spondylitis sacroiliac joint disease were prominently higher than those of CT (P < 0.05). Note that detection rates pertaining to MRI on ankylosing spondylitis, sacroiliac joint disease, erosion of the articular surface, and bone cysts under the articular surface were significantly higher than those of CT (P < 0.05). There exists no significant differences in the detection rates of widening or narrowing and joint ankylosis (P > 0.05). Conclusions: The detection rate of MRI in clinical diagnosis of sacroiliac joint disease of ankylosing spondylitis is higher than that of CT. It possesses excellent clinical promotion and application.
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7

Carter, Shea, Kirsten Braem, and Rik J. Lories. "The role of bone morphogenetic proteins in ankylosing spondylitis." Therapeutic Advances in Musculoskeletal Disease 4, no. 4 (April 18, 2012): 293–99. http://dx.doi.org/10.1177/1759720x12444175.

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Ankylosing spondylitis (AS), the best-known form of spondyloarthritis (SpA), is a remodelling arthritis characterized by chronic inflammation and bone formation. Ankylosis of the axial skeleton and sacroiliac joints leads to an impairment of spinal mobility, progressive spinal fusion and an increased risk of spinal fractures. The nature of the relationship between inflammation and new bone formation in AS has been controversial and questions remain as to whether there is a direct relationship between inflammation and new bone formation. Like others, we have hypothesized that the molecular pathways underlying ankylosis recapitulate the process of endochondral bone formation and that bone morphogenetic proteins (BMPs) play a key role in this process in AS. Furthermore, we discuss the entheseal stress hypothesis, which proposes that inflammation and ankylosis are linked but largely independent processes, and consider observations from mouse models and other human diseases which also imply that biomechanical factors contribute to the pathogenesis of AS. As current therapeutics, such as tumour necrosis factor inhibitors do not impede disease progression and ankylosis in AS, it is the pathways discussed in this review that are the now the focus for the identification of future drug targets.
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8

Stal, Rosalinde, Floris van Gaalen, Alexandre Sepriano, Juergen Braun, Monique Reijnierse, Rosaline van den Berg, Désirée van der Heijde, and Xenofon Baraliakos. "Facet joint ankylosis in r-axSpA: detection and 2-year progression on whole spine low-dose CT and comparison with syndesmophyte progression." Rheumatology 59, no. 12 (May 17, 2020): 3776–83. http://dx.doi.org/10.1093/rheumatology/keaa155.

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Abstract Objectives To evaluate the occurrence and progression of facet joint ankylosis in the whole spine using low-dose CT (ldCT) in radiographic axial spondyloarthritis (r-axSpA) and compare progression of facet joint ankylosis and syndesmophytes. Methods Patients with r-axSpA from the Sensitive Imaging in Ankylosing Spondylitis (SIAS) cohort underwent ldCT at baseline (n = 60) and 2 years (n = 53). Facet joints (right and left, levels C2-S1) were scored as ankylosed, not ankylosed or unable to assess. Joints that were frequently poorly visible (&gt;15% missing), were excluded. Inter-reader reliability on the patient level was assessed with intraclass correlation coefficients (ICCs) and smallest detectable change (SDC). Ankylosis was assessed at joint level and patient level for both timepoints. Syndesmophytes were assessed with CT syndesmophyte score. Results Levels C5-T2 were difficult to assess and excluded from all further analyses. Facet joint ICCs were good to excellent for status scores (0.72–0.93) and poor to excellent for progression scores (0.10–0.91). Facet joint ankylosis was detected at every level but most frequently in the thoracic joints. In total, 48% of patients showed 2-year progression. Most progression occurred in the thoracic segment. Using SDCs as cutoff, 18% of patients had progression of facet joint ankylosis only, whereas 20% of patients had progression of syndesmophytes only. Conclusion This is the first study evaluating facet joints in the whole spine by ldCT in r-axSpA. Facet joint ankylosis was detected most often in the thoracic spine. Assessing facet joints in addition to syndesmophytes detected substantially more patients with damage progression over two years.
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9

Сергей Франк, Михаил Франк, and Георгий Франк. "ИСПОЛЬЗОВАНИЕ МАНУАЛЬНОЙ ТЕРАПИИ В СОЧЕТАНИИ С УДАРНО-ВОЛНОВОЙ ТЕРАПИЕЙ У ПАЦИЕНТОВ С АНКИЛОЗИРУЮЩИМ СПОНДИЛИТОМ." World Science 2, no. 9(49) (September 30, 2019): 28–36. http://dx.doi.org/10.31435/rsglobal_ws/30092019/6708.

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Ankylosing spondylitis is a chronic systemic disease of the connective tissue which affects primarily joints and ligaments of the spine, peripheral joints and internal organs, causing progressive development of limited spinal mobility due to ankylosing of epiphyseal joints, formation of syndesmosis and calcification of vertebral ligaments. There are currently no methods that can completely cure or stop the progression of ankylosing spondylitis, however, manual therapy combined with shock- wave therapy is able to quickly, non-invasively, effectively, economically, safely and without side effects support patients, improving their quality of life, prolonging the duration of the remissions, reducing the frequency of relapses, significantly delaying the development of structural damage and the progression of bone ankylosis. This study discusses the effect of manual therapy combined with shock wave therapy on ankylosing spondylitis resistant to other treatments.
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10

Bouchrane, Ramadhane, Adama Bah, Harine Abdel Aziz Garba, Vanessa Lienou Tagne, Anne Stéphanie Elodie Doun Fouda, Moustapha Niasse, and Saïdou Diallo. "Ankylosing Spondylitis and Right Lower Limb Lymphoedema A Rare Association: A Case Report and Review of the Literature." SAS Journal of Medicine 9, no. 1 (January 14, 2023): 40–46. http://dx.doi.org/10.36347/sasjm.2023.v09i01.009.

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Introduction: Ankylosing spondylitis or rheumatic pelvispondylitis is a chronic inflammatory rheumatism characterized by an axial localization predominantly in the spine and sacroiliac joints, an involvement of the entheses and a tendency to bone ankylosis by ossification of these entheses. We report an observation of right lower limb lymphedema associated with ankylosing spondylitis. Observation: This was a 63-year-old patient with a history of inflammatory rheumatism (his older sister) and osteoporosis (his mother), He was diagnosed with ankylosing spondylitis based on enthesis involvement (bilateral tilted gluteal pain and low inflammatory back pain) with a positive HLA-B27 antigen by the 8-point Amor criteria for spondyloarthritis (right unilateral sacroiliitis, low inflammatory back pain, bilateral tilted gluteal pain, HLA-B27+ and NSAID sensitivity). The unilateral lymphedema with positive Stemmer's sign affected the lower 2/3 of the right lower limb. It occurred one year after the onset of ankylosing spondylitis. The echo-Doppler scan showed no signs of thrombosis or venous infiltration of the lower limbs, and diffuse infiltration of the subcutaneous tissue of the right leg without inflammatory character. Treatment of ankylosing spondylitis gradually improved the lymphedema. Conclusion: Lymphedema is a rare complication of ankylosing spondylitis. Dermatologists should be alert to early swelling of the extremities in patients with ankylosing spondylitis so as not to delay specific multidisciplinary treatment and measures to avoid irreversible lymphatic damage.
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11

Politis, C., Ph Vroninks, and E. Fossion. "Arthroplasty for temporomandibular joint ankylosis secondary to ankylosing spondylitis." Clinical Rheumatology 6, no. 2 (June 1987): 264–69. http://dx.doi.org/10.1007/bf02201033.

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12

Cheung, P. P. M., K. E. Tymms, B. J. Wilson, B. Shadbolt, A. S. Brook, A. K. Dorai Raj, and K. B. K. Khoo. "Infliximab in severe active ankylosing spondylitis with spinal ankylosis." Internal Medicine Journal 38, no. 6a (June 2008): 396–401. http://dx.doi.org/10.1111/j.1445-5994.2007.01599.x.

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13

Hegde, Deepak, Ballal Arjun, Vinay Kumar C., and H. Ravindranath Rai. "TYPE III CAWLEY ANDERSSON LESION IN A CASE OF ANKYLOSING SPONDYLITIS." Journal of Health and Allied Sciences NU 04, no. 02 (June 2014): 136–39. http://dx.doi.org/10.1055/s-0040-1703783.

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Abstract:Ankylosing spondylitis (AS) is a chronic inflammatory disease that affects especially males in the second and third decades of life.1 The main clinical symptom is inflammatory back pain typically occurring at night and morning stiffness improving after exercise.1 Apart from syndesmophytes and ankylosis of the spine resulting in rigidity, in longstanding ankylosing spondylitis, also focal destructive 1 discovertebral lesions (Andersson lesions) can occur.1 The case we present here is of a 35 year old male patient who presented to us with the symptoms of pain of upper back and both shoulders for 6 years. Pain was followed with stiffness of the neck and shoulder. Radiography of the dorsolumbar spine revealed squaring of the vertebra, syndesmophytes, calcification of the anterior spinal ligament, end plate irregularity at D10-D11 level, ill defined sclerosis with fracture of the ankylosed spine, features consistent with Andersson lesion type III. He underwent posterior spinal fusion with good functional outcome.
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Parsanov, S. A., and G. A. Ivanichev. "Dynamics of clinical manifestations of myofascial trigger points. In the rehabilitation of patients with ankylosing arthritis with pondylo." Neurology Bulletin XXVI, no. 3-4 (October 15, 1994): 68–69. http://dx.doi.org/10.17816/nb107188.

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In recent years (Prague), scientific and practical interest in the problems of diseases with ankylosing spondylitis has increased significantly. During the development of the disease, when stiffness of the spine and joints occurs, but ankylosis (stages of preankylosis) has not yet been detected, pain syndromes and muscle spasms prevail in development, the mobility of the chest and joints increases significantly, and foci of changes are not detected.
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15

Tudsri, S., P. Bumrung, K. Siriwatana, and S. Kesprayura. "Ankylosing spondylitis associated with temporomandibular joint ankylosis—Report of case." International Journal of Oral and Maxillofacial Surgery 26 (January 1997): 162. http://dx.doi.org/10.1016/s0901-5027(97)81329-x.

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16

Li, Jiang-Ming, Xue-Wu Zhang, Yi Zhang, Yu-Hui Li, Jin-Gang An, E. Xiao, and Ying-Bin Yan. "Ankylosing spondylitis associated with bilateral ankylosis of the temporomandibular joint." Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology 116, no. 6 (December 2013): e478-e484. http://dx.doi.org/10.1016/j.oooo.2012.02.036.

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17

OHNISHI, Yuichi, Mitsuchika SUGITATSU, Michika NOI, Yoshio MATSUMOTO, and Ikuko YOSHIKAWA. "A case of temporomandibular joint ankylosis caused by ankylosing spondylitis." Japanese Journal of Oral & Maxillofacial Surgery 45, no. 9 (1999): 595–97. http://dx.doi.org/10.5794/jjoms.45.595.

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18

Ohta, Hitoya, and Yoshio Matsumoto. "Temporomandibular joint (TMJ) ankylosis probably caused by ankylosing spondylitis (AS)." Annals of Nuclear Medicine 17, no. 6 (September 2003): 468. http://dx.doi.org/10.1007/bf03006436.

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19

de Oliveira-Neto, Patrício Jose, Erica Cristina Marchiori, Maria Candida de Almeida Lopes, and Roger William Fernandes Moreira. "Bilateral Alloplastic Prostheses for Temporomandibular Joint Reconstruction in a Patient with Ankylosing Spondylitis." Craniomaxillofacial Trauma & Reconstruction 7, no. 2 (June 2014): 149–53. http://dx.doi.org/10.1055/s-0034-1371546.

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Ankylosing spondylitis (AS) or Bechterew disease is a chronic, usually progressive, systemic inflammatory joint disease, which predominantly affects the spine and sacroiliac joints. In these joints, early inflammatory changes are followed by lumbosacral pain and progressive restriction of spinal movement associated with radiologically visible intervertebral ossification. Peripheral joint involvement occurs in 10 to 30% of patients and shows a predilection for the shoulders, knees, ankles, feet, and wrists. Temporomandibular joint (TMJ) involvement has been described, and its reported frequency varies from 11 to 35%. However, ankylosis is uncommon with a single documented case utilizing an alloplastic prosthesis for total joint replacement. A case report of bilateral ankylosis of the jaw treated with alloplastic prostheses for total TMJ replacement using a Brazilian system in a patient with AS is presented.
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20

Putnis, S. E., G. K. Wartemberg, W. S. Khan, and S. Agarwal. "A Literature Review of Total Hip Arthroplasty in Patients with Ankylosing Spondylitis: Perioperative Considerations and Outcome." Open Orthopaedics Journal 9, no. 1 (October 5, 2015): 483–88. http://dx.doi.org/10.2174/1874325001509010483.

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Ankylosing spondylitis is a spondyloarthropathy affecting the sacro-iliac joints with subsequent progression to the spine and the hip joints. The hip joints are affected by synovitis, enthesial inflammation, involvement of medullary bone, progressive degeneration and secondary osteoarthritis. Clinical presentation is usually in the form of pain and stiffness progressing to disabling fixed flexion contractures and in some instances, complete ankylosis. Hip arthroplasty should be considered for hip pain, postural and functional disability, or pain in adjacent joints due to hip stiffness. We conducted a literature review to determine peri-operative considerations and outcome in ankylosing spondylitis patients undergoing hip arthroplasty. In this review, we have discussed pre-operative surgical planning, thromboprophylaxis, anaesthetic considerations and heterotopic ossification. Outcomes of arthroplasty include range of movement, pain relief, survivorship and complications.
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21

Uderhardt, S., D. Diarra, J. Katzenbeisser, J.-P. David, J. Zwerina, W. Richards, G. Kronke, and G. Schett. "Blockade of Dickkopf (DKK)-1 induces fusion of sacroiliac joints." Annals of the Rheumatic Diseases 69, no. 3 (March 19, 2009): 592–97. http://dx.doi.org/10.1136/ard.2008.102046.

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ObjectiveTo study whether Dickkopf (DKK)-1, an inhibitor of wingless (Wnt) signalling, is involved in the fusion of sacroiliac joints.MethodsMice transgenic for tumour necrosis factor (TNFtg mice), which develop bilateral sacroiliitis, were treated with vehicle, anti-TNF antibody or anti-DKK1 antibody. Sacroiliac joints were analysed for histological signs of inflammation, bone erosion, osteoclast formation and ankylosis. Moreover, expression of collagen type X, β-catenin and DKK-1 was assessed by immunohistochemistry.ResultsThere were no signs of spontaneous ankylosis of the sacroiliac joints in TNFtg mice. TNF blockade effectively reduced inflammation, bone erosion and osteoclast numbers in the sacroiliac joints, but did not lead to ankylosis. Blockade of DKK1 had no effect on inflammatory signs of sacroiliitis, but significantly reduced bone erosions and osteoclast counts. Moreover, DKK1 blockade promoted expression of collagen type X, the formation of hypertrophic chondrocytes and ankylosis of sacroiliac joints.ConclusionDKK1 influences inflammatory remodelling of sacroiliac joints by prevention of joint ankylosis. This may indicate an important role of the Wnt signalling pathway in the structural bone changes of axial joint disease. Although this model does not reflect the entire spectrum of ankylosing spondylitis in humans, it helps to explain the pathophysiological processes of sacroiliac joint ankylosis, which is a hallmark of the spondyloarthritides.
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Houzou, P., V. E. S. Koffi-Tessio, S. Oniankitan, K. Kakpovi, E. Fianyo, K. Tagbor, O. Oniankitan, and M. Mijiyaw. "POS1016 ANKYLOSING SPONDYLITIS IN WEST AFRICAN PATIENTS: A SERIES OF 37 CASES REPORTED IN TOGO." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 776.1–776. http://dx.doi.org/10.1136/annrheumdis-2021-eular.4199.

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Background:Spondyloarthritis (SpA) is generally uncommon in sub-Saharan Africa, in part because of the rarity of HLA-B27 in this region.Objectives:The aim of our study was to determine the epidemiological, semiological, paraclinical and therapeutic aspects of ankylosing spondylitis in rheumatology in Togo.Methods:This was a retrospective multicenter descriptive study on the files of patients suffering from ankylosing spondylitis seen in an outpatient setting or hospitalized in one of the four Rheumatology departments of Togo in the period from January 1, 2000 to December 31, 2019. The diagnosis was essentially radio-clinical based on the modified New York criteria.Results:In 20 years, and out of a population of 35,304 rheumatic patients, we have collected 37 cases of ankylosing spondylitis, meaning a hospital frequency of 0.10% and an annual frequency of 1.85 cases. There was clearly a male predominance with an M / F ratio of 4.28. The onset of the disease was on average of 29.62 ± 10.27 years and the diagnosis delay on average of 9.45 ± 9.20 years. The clinic was dominated by spinal pain in the form of chronic inflammatory cervical-dorsal-lumbar pain (41.2%) or lumbar pain (29.4%). Common joint injuries were those of the knees (57.69%), ankles (26.9%) and shoulders (23.1%). The most frequent extra-articular manifestations were ocular with conjunctivitis (62.5%) and uveitis (37.5%). Due to the delayed diagnosis, significant spinal deformities including hypercyphosis, straightness and ankylosis were found; the radiography of the spine objectified syndesmophytes (50.0%) with ankyloses and the bamboo column (23.5%) and that of the pelvis objectified sacroiliitis at stage 3 (54.6%) and at stage 4 (27.3%). The HLA B27 antigen was positive in 10.8% of cases. NSAIDs and sulfasalazine were the most commonly used drugs in management, respectively in 94.3% of symptomatic treatment and 92.6% of background therapy.Conclusion:Ankylosing spondylitis is relatively rare in Togo, affecting more men and young adults. There are no clinical or paraclinical particularity. The delay in diagnosis reflects the importance of the radiological signs. Treatment is mainly done by NSAIDs and DMRADs in particular sulfasalazine, due to their accessibility.References:[1]Dean LE, Jones GT, MacDonald AG, Downham C, Sturrock RD, Macfarlane GJ. Global Prevalence of Ankylosing Spondylitis. Rheumatology (Oxford). 2014;53:650-7.[2]Zabsonre TWJ, Sawadogo SA, Kabore F, Ilboudo A, Sougue C, Zongo E, et al. Ankylosing Spondylitis in Sub-Saharan Africa: A Series of 48 Cases Reported in Burkina Faso (West Africa). Open J Rheumatol Autoimmune Dis. 2018;8:87-92.[3]Mijiyawa M. Ankylosing Spondylitis in Togolese Patients. Med Trop. 1993;53:185-9.Disclosure of Interests:None declared.
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Kufterin, V. V., and M. K. Karapetian. "On the differential diagnosis of vertebral ankyloses in paleoanthropological material: an example of the Early Iron Age case from the Lower Kama region." VESTNIK ARHEOLOGII, ANTROPOLOGII I ETNOGRAFII, no. 3 (50) (August 28, 2020): 120–32. http://dx.doi.org/10.20874/2071-0437-2020-50-3-10.

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Differentiating various pathological conditions involving the spine, particularly those leading to vertebral anky-losis, is a challenging task both in paleopathology and clinical practice. The Introduction summarizes cases of ankylosing spondylitis (Bekhterev’s disease) and diffuse idiopathic skeletal hyperostosis (Forestier disease) from the territory of former USSR. In this regard, it is important to mention that, having different etiologies, DISH and seronegative spondyloarthropathies have different reconstructive potential. It is assumed that the increase in DISH prevalence may be associated with an increase in life expectancy and characteristics of the group’s nutri-tional status, while spondyloarthropathies – with endogamy, increased population density due to sedentary life-style and the intensification of agriculture. It is noted that differential diagnostic procedure has been reported only in few Russian-language publications that deal with the topic. This often leads to the statement of not quite justi-fied paleopathological diagnoses. This paper presents results of paleopathological study of a 25–40-year-old male skeleton from burial 183 of the Novo-Sasykul cemetery, dated to the 1st–2nd centuries AD. The site is located in the Lower Kama River region (Bakalinsky District, Republic of Bashkortostan) and attributed to the Pyany Bor Culture. The study is focused on differentiating pathological conditions that lead to vertebral ankylosis on skeletal remains. Principal pathological changes, recorded on the skeleton from burial 183 of the Novo-Sasykul cemetery, were: 1) ankylosis of five consecutive thoracic vertebrae (T7–11) with right-sided ossification of the anterior longi-tudinal ligament and 2) bilateral fusion of the sacroiliac joints. Possible diagnoses include seronegative spondy-loarthropathies (ankylosing spondylitis, reactive and psoriatic arthritis), diffuse idiopathic skeletal hyperostosis (DISH), rheumatoid arthritis, and degenerative changes (osteoarthritis). The differential diagnosis based on mac-roscopic (morphological) indicators allows suggesting a diagnosis of DISH, possibly associated with a spondy-loarthropathy and minor degenerative changes in the spine. Ankylosing spondylitis is certainly excluded from the spectrum of probable spondyloarthropathies. It is noted, however, that specific diagnosis requires an X-ray exa-mination. As a guideline for the specialists, the need for careful differentiation between different pathological con-ditions leading to ankylosis of vertebral segments is emphasized. The latter is important, since reporting ill-considered diagnosis may severely complicate the use of the published data in bioarchaeological reconstructions.
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Brkic, Zlata, Nikola Pijevcevic, Verica Pavlic, and Milan Petronijevic. "Oral rehabilitation of a patient with temporomandibular joint ankylosis caused by ankylosing spondylitis: A case report." Vojnosanitetski pregled 74, no. 4 (2017): 374–77. http://dx.doi.org/10.2298/vsp150522189b.

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Introduction. Ankylosing spondylitis (AS)/Morbus Bechterew is a chronic inflammatory rheumatoid disease. The temporomandibular joint (TMJ) dysfunction is involved in 4?35% of AS cases, and is correlated to the severity and extension of AS. Even though AS-caused TMJ ankylosis is exceptional, one should have high index of suspicion of TMJ ankylosis in AS for an early detection, because it is an extremely serious and disabling condition that causes problems with mastication, swallowing, digestion, speech, appearance and poor oral hygiene with heavy caries. Case report. A 54-year-old male patient sought medical attention at the Department of Periodontology and Oral Medicine, Clinic for Dentistry at the Military Medical Academy, Belgrade, Serbia, with the chief complaint of pain in the area of the upper left canine in the presence of limited mouth opening. The treatment plan consisted of upper left canine management and rehabilitation of the remaining teeth in the frontal and the premolar region in both, the upper and lower jaw. Even though molar region needed to be treated, unfortunately it was not in the treatment plan because ankylosis of TMJ made the treatment impossible. Conclusions. The patients with AS-caused TMJ ankylosis are considered a diagnostic challenge to routine dentistry. Accent should be given to early diagnosis and multidisciplinary approach in the treatment of the AS patients towards the favorable disease course and outcome.
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Verhoeven, Frank, Xavier Guillot, Marie Godfrin-Valnet, Clément Prati, and Daniel Wendling. "Ultrasonographic Evaluation of the Anterior Chest Wall in Spondyloarthritis: A Prospective and Controlled Study." Journal of Rheumatology 42, no. 1 (November 1, 2014): 87–92. http://dx.doi.org/10.3899/jrheum.140409.

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Objective.To determine the prevalence and type of ultrasonographic (US) lesions of the anterior chest wall (ACW) in cases of spondyloarthritis (SpA).Methods.This monocentric, prospective, and controlled study included patients consulting for SpA (Assessment of Spondyloarthritis International Society criteria) and control subjects. Clinical (pain and swelling) and US assessments (synovitis, joint effusion, erosion, ankylosis, margin narrowing, or Doppler signal) were performed on the sternoclavicular (SCJ) and the manubriosternal (MSJ) joints. The main characteristics of SpA were recorded [disease duration, biologic features, Ankylosing Spondylitis Disease Activity Score (ASDAS), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), radiographic and extraarticular involvement].Results.The study included 131 patients with SpA and 49 control subjects (same age and sex ratio). Clinical and US involvement of ACW were found in, respectively, 39% and 35.5% of SpA and in 12% and 14.3% of controls (p < 0.01). US highlighted erosions (34 vs 0), margin narrowing (12 vs 0), power Doppler activity (18 vs 2; p < 0.05), and ankylosis of the MSJ (24 vs 3). US involvement was associated with disease duration (14.9 vs 11.1 years; p = 0.04), age (45 vs 41 years; p = 0.004), radiographic change of sacroiliac joint (p = 0.05), and presence of inflammatory bowel disease (IBD; p = 0.03). No associations were found with HLA-B27, psoriasis, enthesitis, uveitis, or clinical involvement of ACW. Clinical involvement is associated with a higher BASDAI (47 vs 32; p = 0.0009) and ASDAS (2.9 vs 2.2; p = 0.006).Conclusion.US involvement of ACW is frequent in SpA (36.5%), mainly with erosion of SCJ and ankylosis of MSJ. It is associated with disease duration, radiographic sacroiliitis, and IBD.
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Younus, Raheel, Tazeem Akhtar, Hafiz Syed Ijaz Ahmed Burq, Rabbiya Sarwar, Wadha Kamran, and Ahmed Jamal. "Effects of Brief Intervention of Behavioural Change on Pain, Mobility, Function, and Quality of Life in Patients with Chronic Ankylosing Spondylitis: A Randomised Clinical Trial." Pakistan Journal of Medical and Health Sciences 16, no. 9 (September 30, 2022): 528–31. http://dx.doi.org/10.53350/pjmhs22169528.

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Background: Exercise is essential for maintaining the flexibility and functionality of the joints in patients with ankylosing spondylitis. Additionally, it could ease pain, enhance posture, correct muscular imbalances, facilitate breathing, and generally enhance the quality of life. However, since patient education is poorly structured, patients fail to consider this significant element. Objective: To determine the effects of brief intervention of behavioural change on pain, mobility, function, and quality of life in patients with chronic ankylosing spondylitis Methods: This was a randomized controlled trial with 80 patients in two groups: brief intervention and control. Purpose sampling was used to enrol ankylosing spondylitis patients aged 18 to 60 with stable medical management. Patients with respiratory, cardiac, neurological, pregnancy, or inability to walk unassisted were excluded. All participants provided written informed consent. Cardiorespiratory test duration, physical activity duration per week, flexibility measured by chest expansion, back pain usual, back pain at night, global disease activity, Bath Ankylosing Spondylitis Functional Index (BASFI) and Ankylosing Spondylitis Quality of Life (ASQoL) scale. Week 0 before treatment, 6th week end, and 12th week follow-up were assessed. Data was analysed in SPSS 25.0. Results: The results showed that the demographic variables were equally distributed in both groups without a significant association to any group (p value >0.05) except for urban residence where urban residents were having more percentage of ankylosis spondylitis. The results regarding outcome variables post-interventional 8th week showed that Cardiorespiratory test duration 881±(47.23) and 812±(56.89), Flexibility, chest expansion 6.7±(2.75) and 5.2±(2.14), Back pain usual 2.7±(0.79) and 3.4±(1.04), Back pain at night 3.8±(1.78) and 4.4±(1.54), Global disease activity 6.2±(1.97) and 6.7±(2.03), Bath Ankylosing Spondylitis Functional Index (BASFI) 7.4±(1.16) and 7.2±(1.69) and Ankylosing Spondylitis Quality of Life (ASQoL) scale 12.6±(1.25) and 15.7±(1.05). while the p value (<0.05) showed significant difference in favour experimental group, brief intervention for all variables. Similarly, the follow up results measured at 16th week were significantly different in favour experimental group, brief intervention for all variables, p value (<0.05 Conclusion: The findings of study concluded that brief intervention-based health improving physical activity was significantly on pain, mobility, function, and quality of life in patients with chronic ankylosing spondylitis. Keywords: Brief Intervention, Physical Activity, Ankylosing Spondylitis, Back Pain, Spinal Mobility
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Jo, S., J. S. Lee, B. Nam, Y. L. Lee, H. Kim, E. Y. Lee, Y. S. Park, and T. H. Kim. "SOX9+ enthesis cells are associated with spinal ankylosis in ankylosing spondylitis." Osteoarthritis and Cartilage 30, no. 2 (February 2022): 280–90. http://dx.doi.org/10.1016/j.joca.2021.11.013.

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O'Rielly, D. D., Y. Zhang, N. Al-Ghanim, R. Ardern, A. Munn, S. Hamilton, R. Bricknell, G. Zhai, and P. Rahman. "OP0018 Epigenetic Study of Advanced Ankylosis in Patients with Ankylosing Spondylitis." Annals of the Rheumatic Diseases 73, Suppl 2 (June 2014): 66.3–66. http://dx.doi.org/10.1136/annrheumdis-2014-eular.3270.

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Rogers, J., I. Watt, and P. Dieppe. "Palaeopathology of spinal osteophytosis, vertebral ankylosis, ankylosing spondylitis, and vertebral hyperostosis." Annals of the Rheumatic Diseases 44, no. 2 (February 1, 1985): 113–20. http://dx.doi.org/10.1136/ard.44.2.113.

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Koo, Bon San, Yoonah Song, Kyung Bin Joo, Seunghun Lee, and Tae-Hwan Kim. "Radiologic Changes in the Symphysis Pubis of Male Patients with Ankylosing Spondylitis." Journal of Rheumatology 43, no. 2 (December 15, 2015): 330–34. http://dx.doi.org/10.3899/jrheum.150711.

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Objective.We aimed to evaluate the involvement of the symphysis pubis in patients with ankylosing spondylitis (AS), and to assess the correlations between symphysis pubis changes and clinical findings.Methods.We retrospectively evaluated a total of 222 male patients with AS who underwent pelvic and cervical/lumbar spine radiography at the Hanyang University Hospital for Rheumatic Diseases from August 2004 to February 2014. Radiographs were examined by 2 experienced radiologists, and radiographic damage was scored as follows: 0 (no damage), 1 (subtle irregularity and/or subchondral sclerosis), 2 (erosion), 3 (partial ankylosis), and 4 (total ankylosis). We evaluated the patients’ clinical characteristics and analyzed their correlations with radiographic symphysis pubis changes.Results.The mean patient age was 30.5 ± 8.3 years and mean disease duration was 7.1 ± 4.6 years; 105 patients (47.3%) exhibited radiologic damage in the symphysis pubis. Moreover, 75, 28, 0, and 2 patients had scores of 1, 2, 3, and 4, respectively. When comparing the normal (score 0) and abnormal (score 1–4) symphysis pubis groups, the latter had a longer symptom duration (10.1 ± 7.0 vs 7.6 ± 5.8 yrs, p = 0.004) and higher modified Stoke Ankylosing Spondylitis Spine Score (mSASSS; 18.6 ± 17.0 vs. 14.3 ± 13.4, p = 0.038). Moreover, a significant correlation was noted between the radiographic symphysis pubis damage score and mSASSS (r2 = 0.147, p = 0.029).Conclusion.Among male patients with AS, 47.3% exhibited symphysis pubis involvement. Moreover, a correlation was observed between the radiographic symphysis pubis and spine changes.
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Kanda, Naoki, Koichi Takeda, Shuji Hatakeyama, and Masami Matsumura. "Ankylosing spondylitis presenting with enthesitis at an uncommon site and fever of unknown origin." BMJ Case Reports 12, no. 8 (August 2019): e230113. http://dx.doi.org/10.1136/bcr-2019-230113.

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A 58-year-old man presented with a 2-month history of arthralgia and bilateral temporal region pain, and a 1-month history of fever. He had had refractory neck pain since his 20s. Reduced cervical and lumbar mobility was observed. Radiographs of cervical and thoracic vertebrae disclosed syndesmophytes. Pelvic radiographs showed sclerosis in the right sacroiliac joint and ankylosis in the left sacroiliac joint. MRI with contrast enhancement showed enthesitis in the upper extremities and enhancement in the bilateral temporal muscle, which indicated enthesitis of temporal muscle. He was diagnosed with ankylosing spondylitis based on the limitation in mobility of the lumbar spine and radiographic findings. To the best of our knowledge, this is the first report describing enthesitis of the temporal muscle. This case highlights that ankylosing spondylitis can be accompanied with enthesitis at the temporal muscle and fever of unknown origin at the initial presentation.
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Kayani, Mohammad Danyal. "A Case Report on Ankylosing Spondylitis in a Pakistani Patient." International Journal of Scientific & Engineering Research 11, no. 07 (July 25, 2020): 261–66. http://dx.doi.org/10.14299/ijser.2020.07.08.

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Background: Ankylosing Spondylitis is the most common type of seronegative spondyloarthropathy. It is characterized by inflammation of multiple articular and para-articular structures, which in turn often leads to osseous ankylosis. Objective: This case is relatively uncommon in Pakistani population especially in females, and to compare the clinical presentation of the condition in this Pakistani patient with what is known around the world using the Criteria widely recognized internationally. Materials and Methods: A case report of a 51-year-old Pakistani woman with a history of back pain and radiographic imagery showing the classical findings of Ankylosing Spondylitis. Results: The Patient is a known case of diabetes mellitus, hypertension and primary hypothyroidism, and has been suffering from chronic lower back pain and stiffness for more than 16 years now. Her symptoms are worst in the morning soon after waking up from sleep. She has restricted movements at hip joints and kyphosis on examination. She also has reduced chest expansion. Her X-rays shows typical bamboo spine appearance with syndesmophytes formation and squaring of vertebral bodies. Her presentation fits both European Spondyloarthropathy Study Group diagnostic criteria for spondyloarthropathies, and the modified New York Criteria. Conclusion: This patient shows typical clinical and radiological findings of the Ankylosing Spondylitis, and fulfills the requirement of the diagnostic criterion
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Ye, Chuan, Riguang Liu, Changying Sun, Jianhao Lin, Hu Li, Houxiang Re, Bo Sun, Qi Sun, and Long Yang. "Cementless bilateral synchronous total hip arthroplasty in ankylosing spondylitis with hip ankylosis." International Orthopaedics 38, no. 12 (July 17, 2014): 2473–76. http://dx.doi.org/10.1007/s00264-014-2461-4.

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IWAMA, Ryosuke, Shinnosuke NOGAMI, Sou YOKOTA, Yuri TAKEDA, Kensuke YAMAUCHI, and Tetsu TAKAHASHI. "A case of temporomandibular ankylosis associated with ankylosing spondylitis treated by arthroplasty." Japanese Journal of Oral and Maxillofacial Surgery 64, no. 10 (October 20, 2018): 582–87. http://dx.doi.org/10.5794/jjoms.64.582.

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Farisogullari, B., G. K. Yardimci, E. Bilgin, E. C. Bolek, E. Duran, G. Ayan, Z. Özsoy, et al. "POS0991 PREDICTORS OF DEVELOPMENT OF ADVANCED SPINAL ANKYLOSIS/BAMBOO SPINE IN AXIAL SPONDYLOARTHRITIS: RESULTS FROM REAL-LIFE DATA." Annals of the Rheumatic Diseases 81, Suppl 1 (May 23, 2022): 803.2–804. http://dx.doi.org/10.1136/annrheumdis-2022-eular.3661.

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BackgroundIn axial spondyloarthritis (axSpA), intervertebral ossification bridges of consecutive vertebrae may progress to advanced spinal ankylosis and bamboo spine over the years [1].ObjectivesTo identify demographic, clinical, disease activity and treatment factors associated with development of bamboo spine / advanced spinal ankylosis and bamboo spine-only in the Hacettepe University Rheumatology Biologic Registry (HUR-BIO) cohort.MethodsHUR-BIO is a prospective, single center database of biological disease-modifying antirheumatic drug (bDMARD) treatments. 770 patients on bDMARDs treatment had both lumbar and cervical lateral radiographies at the time of the data collection, and were included in the study. Bamboo spine was defined Bath Ankylosing Spondylitis Radiologic Index (BASRI)-spine grade 4 with a complete fusion of lumbar and cervical spines. Advanced spinal ankylosis was defined as the presence of at least two intervertebral adjacent bridges and/or fusion at the lumbar and/or cervical spine without bamboo spine. We analyzed the ensemble of variables by multivariable logistic regression to identify predictors associated with bamboo spine / advanced spinal disease, and bamboo spine-only.ResultsIn the study, there were 99 patients with advanced spinal ankylosis and 78 patients with bamboo spine. Older age (OR 1.12, 95% CI 1.07-1.17), male gender (OR 4.26, 95% CI 1.75-10.41), delay diagnosis ≥ 24 months (OR 2.7, 95% CI 1.27-5.74), obesity (OR 4.03, 95% CI 1.53-10.64), hip involvement (OR 4.94, 95% CI 1.94-12.6), smoking ≥ 10 package/year (OR 2.28, 95% CI 1.003-5.2) were significantly associated factors with bamboo spine / advanced spinal ankylosis. Similarly, older age (OR 1.17, 95% CI 1.09-1.3), male gender (OR 8.31, 95% CI 2.09-33.1), obesity (OR 5.15, 95% CI 1.25-21.27), hip involvement (OR 4.74, 95% CI 1.32-16.96) and smoking ≥ 10 package/year (OR 3.19, 95% CI 1.03-9.89) were showed statistical significance with bamboo spine (Table 1).Table 1.Predictors of Bamboo Spine and Advanced Spinal Ankyloses, and Bamboo Spine-onlyMultivariable ModelCovariatesBamboo Spine and Advanced Spinal AnkylosisBamboo SpineOR (95% CI)p-valueOR (95% CI)p-valueAge1.12 (1.07-1.17)<0.001*1.17 (1.09-1.3)<0.001*Male (vs female)4.26 (1.75-10.41)0.001*8.31 (2.09-33.1)0.003*Delay Diagnosis (≥ 24 months vs <24 months)2.7 (1.27-5.74)0.01*2.39 (0.85-6.71)0.09BMI0.019*0.074- 25 to < 30 (vs <25)2.05 (0.77-5.46)0.153.37 (0.84-13.6)0.087- ≥ 30 (vs <25)4.03 (1.53-10.64)0.005*5.15 (1.25-21.27)0.024*Hip involvement (present vs absent)4.94 (1.94-12.6)0.001*4.74 (1.32-16.96)0.017Smoking (≥ 10 package/year vs <10 package/year)2.28 (1.003-5.2)0.049*3.19 (1.03-9.89)0.044*Family History of SpA (First-degree; present vs absent)1.67 (0.61-4.57)0.322.82 (0.79-10.06)0.11Uveitis History (present vs absent)1.04 (0.39-2.74)0.941.19 (0.33-4.29)0.79Use SSZ (present vs absent)0.6 (0.17-2.07)0.422.09 (0.39-11.28)0.39Use Corticosteroids (present vs absent)0.69 (0.27-1.75)0.430.73 (0.18-2.97)0.66*p <0.05BMI: Body mass index; SpA: Spondyloarthritis; SSZ: SulfasalazineConclusionData on the predictors of development of advanced spinal ankylosis and bamboo spine are scarce. In this study, we showed that older age, male gender, delay in diagnosis, obesity, hip involvement and smoking are factors that predict the development of advanced spinal involvement in axSpA.References[1]Ostergaard M, Lambert RG. Imaging in ankylosing spondylitis. Ther Adv Musculoskelet Dis. 2012;4(4):301-11.Disclosure of InterestsNone declared
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Gupta, Nikhil, Nishtha Gupta, LaxmikantRamkumarsingh Tomar, and Nikhil Nair. "Temporomandibular joint ankylosis in ankylosing spondylitis: A case report and review of literature." Journal of Family Medicine and Primary Care 5, no. 3 (2016): 716. http://dx.doi.org/10.4103/2249-4863.197292.

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Chow, T. K., W. L. Ng, C. K. Tarn, and N. Kung. "Bilateral Ankylosis of Temporomandibular Joint Secondary to Ankylosing Spondylitis in a Male Chinese." Scandinavian Journal of Rheumatology 26, no. 2 (January 1997): 133–34. http://dx.doi.org/10.3109/03009749709115833.

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McKean, David, Alpesh Kothari, Jane Chen, Richard Sidebottom, Victoria Chan, Sarah Yanny, and James L. Teh. "Co-existing Paget's disease and ankylosing spondylitis resulting in panthoracic pagetic vertebral ankylosis." BJR|case reports 2, no. 2 (May 2016): 20150405. http://dx.doi.org/10.1259/bjrcr.20150405.

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Jo, S., B. S. Koo, B. S. Koo, I. H. Sung, I. H. Sung, Y. S. Park, Y. S. Park, et al. "OP0270 Targeting IL-23 Can Attenuate Progression of Spinal Ankylosis in Ankylosing Spondylitis." Annals of the Rheumatic Diseases 75, Suppl 2 (June 2016): 160.3–161. http://dx.doi.org/10.1136/annrheumdis-2016-eular.3872.

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Feng, Dong-xu, Kun Zhang, Yu-min Zhang, Yue-wen Nian, Jun Zhang, Xiao-min Kang, Shu-fang Wu, and Yang-jun Zhu. "Bilaterally Primary Cementless Total Hip Arthroplasty for Severe Hip Ankylosis with Ankylosing Spondylitis." Orthopaedic Surgery 8, no. 3 (August 2016): 352–59. http://dx.doi.org/10.1111/os.12254.

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Qin, Lizheng, Xing Long, Xiaodan Li, and Mohong Deng. "Bilateral fibrous ankylosis of temporomandibular joint associated with ankylosing spondylitis: a case report." Joint Bone Spine 73, no. 5 (October 2006): 576–78. http://dx.doi.org/10.1016/j.jbspin.2005.11.003.

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Bhan, Surya, Krishna Kiran Eachempati, and Rajesh Malhotra. "Primary Cementless Total Hip Arthroplasty for Bony Ankylosis in Patients with Ankylosing Spondylitis." Journal of Arthroplasty 23, no. 6 (September 2008): 859–66. http://dx.doi.org/10.1016/j.arth.2007.07.014.

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de Andrade Freitas Oliveira, Luciana Soares, Christiano de Oliveira-Santos, Daniela Pita de Melo, Marianna Guanaes Gomes Torres, and Paulo Sérgio Flores Campos. "Unilateral bony ankylosis of the temporomandibular joint in a case of ankylosing spondylitis." Oral and Maxillofacial Surgery 17, no. 3 (October 11, 2012): 213–17. http://dx.doi.org/10.1007/s10006-012-0365-2.

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Dubinin, A. O., A. E. Khramov, T. V. Dubinina, E. V. Ilinykh, and E. I. Bialik. "Intraoperative picture of hip joint lesion in ankylosing spondylitis: data from a retrospective analysis." Rheumatology Science and Practice 60, no. 5 (November 11, 2022): 594–98. http://dx.doi.org/10.47360/1995-4484-2022-594-598.

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In population of Russian patients with ankylosing spondylitis (AS), the frequency of clinical manifestations (pain and limitation of functions) of coxitis reaches 56%. Total hip arthroplasty (THA) can be considered as the only alternative that can relieve the suffering of the patient. Radiography and magnetic resonance imaging are widely used methods for assessing structural damage to the hip joint in AS. However, at the moment these methods can’t allow us to fully describe the lifetime changes of these joints. The aim of the study: to analyze the external changes of the femoral heads (HF) and acetabulums during the THA in patients with AS. Materials and methods. The retrospective study included 170 patients with a reliable diagnosis of AS, who met the modified New York criteria of 1984, who were treated in the traumatological and orthopedic department of the V.A. Nasonova Research Institute of Rheumatology in the period from 1998 to 2020, all patients underwent THA as planned. Most of them were male (80.6%). The average age of patients was 38.1±11.3 years and the average duration of the disease since the onset of the first symptoms was 17.0±8.5 years. The duration of pain in hip joints before performing THA is 7.4±4.8 years. The assessment of macroscopic changes in the FH and acetabulum was performed intraoperatively. Results and discussion. Acetabulum protrusion was detected in 108 (63.5%) patients, bone cysts – in 65 (38.2%). Filling of acetabulum with granulation tissue was recorded in 155 (91.2%) patients, presence of osteophytes on its edges – in 153 (90%). Cartilage in the acetabulum was completely absent in 122 (71.8%) patients. FH deformation was detected in 98.2% of cases, erosion in 46.4%. Cartilage on FH was completely absent in 130 (76.5%) patients. In 119 (70%) patients, macroscopic signs of osteonecrosis of FH were found. 79 (46.4%) patients had ankylosis of the hip joint, including fibrous ankylosis – in 77.2% of patients and bone ankylosis – in 22.8%. Conclusion. In patients with AS, the necessity for THA occurs on average after 7.4±4.8 years from the moment of the appearance of first clinical signs of coxitis. In 70% of cases, the macroscopic picture of hip joint lesion was characterized by the development of Avascular necrosis of the femur head (AVNFH), in most patients there was no cartilage in the most loaded segments of acetabulum and FH, in almost half of cases – ankylosis of hip joint and mainly fibrous (77.2%).
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N Osadebey, Emmanuel, Karnesha Goins, Cierra N Harper, and Damirez Fossett. "Deformity correction in the setting of acute cervical spine trauma in a patient with ankylosing spondylitis: A case report." Journal of Case Reports and Images in Surgery 8, no. 2 (November 23, 2022): 31–37. http://dx.doi.org/10.5348/100110z12eo2022cr.

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Introduction: Ankylosing spondylitis (AS) is an autoimmune spondyloarthropathy marked by symptomatic alterations in skeletal anatomy and biomechanics. Ankylosis from the ossification of ligamentous structures and adjacent joints transforms the spine from flexible to rigid and brittle, easily susceptible to fracture. The pathophysiology of the condition is also notable for a progressive debilitating cervical kyphosis known as “chin-on-chest.” Ultimately, the combination of a brittle, rigid, spine can permit trivial trauma to cause catastrophic injury, and in some instances, mortality. We discuss the multi-disciplinary approach, management concerns, and deformity correction in the setting of traumatic cervical spine fracture in a patient with ankylosing spondylitis. Case Report: A 71-year-old man with ankylosing spondylitis presented to Howard University Hospital in a delayed fashion after a ground level fall at home. Neurological examination revealed loss of all motor and sensory function below the C4 level and an absence of rectal tone. Advanced imaging discovered a fracture-dislocation at the C4-5 level producing a severe hyper-lordotic angulation deformity. The profound fracture characteristics and displacement caused spinal cord compression posteriorly and tracheoesophageal stenosis anteriorly. The patient was treated operatively in a staged dual approach fashion correcting his pathologic deformity in consideration of long-term care needs. Postoperatively, upon completion of his final neurosurgical procedure, his sensory exam notable for return of sensation from C5-T1 and he was also able to appreciate and interact with the environment around him as his viewpoint was no longer rigidly caudally oriented. The patient was discharged from the hospital to a long-term care facility in stable condition. Conclusion: Cervical fractures sustained after minor trauma in a patient with ankylosing spondylitis are not uncommon. However, surgical intervention with concomitant deformity correction in the traumatic setting is substantial undertaking with a paucity of literature on such surgical techniques. Surgical deformity correction in the acute trauma setting allowed for optimization of anticipated medical care initiatives and successfully provided newfound visual awareness of his environment, improving upon his ability to interact with the world.
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Lee, Jeong Hoon, Seunghun Lee, Bong Gun Lee, Soon Young Song, Tae-Hwan Kim, and Young Bin Joo. "Manifestations of Cervical Spine Involvement in Longstanding Ankylosing Spondylitis: Atlantoaxial Ankylosis and Atlantoaxial Subluxation." Journal of Rheumatic Diseases 24, no. 1 (2017): 21. http://dx.doi.org/10.4078/jrd.2017.24.1.21.

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CHEN, HUNG-AN, CHUN-HSIUNG CHEN, YEONG-JANG LIN, PEI-CHIH CHEN, WEI-SHENG CHEN, CHIN-LI LU, and CHUNG-TEI CHOU. "Association of Bone Morphogenetic Proteins with Spinal Fusion in Ankylosing Spondylitis." Journal of Rheumatology 37, no. 10 (August 3, 2010): 2126–32. http://dx.doi.org/10.3899/jrheum.100200.

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Objective.To measure serum concentrations of bone morphogenetic proteins (BMP) in patients with ankylosing spondylitis (AS), and to investigate the relationship between BMP and clinical manifestations and radiographic changes.Methods.We studied 60 consecutive AS patients with and 60 patients without spinal fusion. Spinal radiographs were assessed using the Bath Ankylosing Spondylitis Radiology Index (BASRI) and the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). Spinal fusion was defined as the presence of total bony bridging between 2 adjacent vertebral bodies in either the lumbar or cervical spine. Serum levels of BMP were determined by enzyme-linked immunosorbent assay.Results.Patients with spinal fusion had higher serum levels of BMP-2 and BMP-4 than either the healthy controls or patients without spinal fusion (p < 0.001), but there was no difference between the latter 2 groups. Serum BMP-7, erythrocyte sedimentation rate, and C-reactive protein (CRP) levels were elevated in patients with spinal fusion compared with those without (p < 0.05). Serum BMP-4 and BMP-7 levels were higher in patients with hip involvement than in those without (p < 0.05). BMP-2 and BMP-4 levels had a significant correlation with spinal radiograph scores, especially for BASRI of the lumbar spine (r = 0.356 and 0.348, respectively, p < 0.001). CRP showed a significant correlation with spine BASRI and mSASSS scores (r = 0.261 and 0.260, respectively, p < 0.05).Conclusion.Rising levels of BMP in AS patients with spinal fusion and the positive correlation between BMP and spinal radiograph scores indicate that BMP may play a role in the process of spinal ankylosis. Serum levels of BMP may reflect radiographic progression of the spine and hip joints.
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PIMENTEL-SANTOS, FERNANDO MANUEL, DARIO LIGEIRO, MAFALDA MATOS, ANA FILIPA MOURÃO, ELSA VIEIRA de SOUSA, PATRICIA PINTO, ANA RIBEIRO, et al. "ANKH and Susceptibility to and Severity of Ankylosing Spondylitis." Journal of Rheumatology 39, no. 1 (November 15, 2011): 131–34. http://dx.doi.org/10.3899/jrheum.110681.

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Objective.Unconfirmed reports describe association of ankylosing spondylitis (AS) with several candidate genes including ANKH. Cellular export of inorganic pyrophosphate is regulated by the ANK protein, and mutant mice (ank/ank), which have a premature stop codon in the 3’ end of the ank gene, develop severe ankylosis. We tested the association between single-nucleotide polymorphisms (SNP) in these genes and susceptibility to AS in a population of patients with AS. We investigated the role of these genes in terms of functional (BASFI) and metrological (BASMI) measures, and the association with radiological severity (mSASSS).Methods.Our study was conducted on 355 patients with AS and 95 ethnically matched healthy controls. AS was defined according to the modified New York criteria. Four SNP in ANKH (rs27356, rs26307, rs25957, and rs28006) were genotyped. Association analysis was performed using Cochrane-Armitage and linear regression tests for dichotomous and quantitative variables. Analyses of Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), BASFI, and mSASSS were controlled for sex and disease duration.Results.None of the 4 markers showed significant single-locus disease associations (p > 0.05), suggesting that ANKH was not a major determinant of AS susceptibility in our population. No association was observed between these SNP and age at symptom onset, BASDAI, BASFI, BASMI, or mSASSS.Conclusion.These results confirm data in white Europeans that ANKH is probably not a major determinant of susceptibility to AS. ANKH polymorphisms do not markedly influence AS disease severity, as measured by BASMI and mSASSS.
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Zhou, W., M. He, R. Zhao, C. Dong, and Z. Gu. "AB1331-HPR ACTIVE DISEASE ACTIVITY IN ANKYLOSIS SPONDYLITIS: WORSE OUTCOMES AND POORER HR-QOL." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 1954.2–1954. http://dx.doi.org/10.1136/annrheumdis-2020-eular.6288.

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Background:Ankylosing spondylitis (AS) is a chronic inflammatory disease that mainly affects the sacroiliac joints and the spine, resulting in decline in quality of life[1,2]. Poor QoL is significantly related to high disease activity[3]. However, there is no systematic report on which prognosis indicators are affected by disease activity in AS patients.Objectives:This study aimed to evaluate the patient-reported outcome measures and health-related quality of life (HR-QoL) in AS patients defined on the basis of the Bath Spondylitis Ankylosing Disease Activity Index (BASDAI).Methods:204 AS patients were involved in this study. A serious of questionnaires were used to overall assess AS patients, which include: Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Bath Ankylosing Spondylitis Functional Index (BASFI), the 10 cm Visual Analog Scale (VAS), the Self-Rating Anxiety Scale (SAS), the Self-Rating Depression Scale (SDS), the Pittsburgh Sleep Quality Index (PSQI), the Health Assessment Questionnaire-Disability Index (HAQ-DI), the Fatigue Severity Scale(FSS) and the Short Form 36 Health Survey (SF-36). Independent samples t-test, Mann–Whitney U-test, Chi-square analysis and Pearson /Spearman correlation were used to analyze the data.Results:The results demonstrated 31.4% AS patients were in active disease activity stage. Active AS patients were older, unemployed, and had less exercise therapy than stable AS patients. Besides, AS patients with active disease activity presented more severe pain(P<0.001), poor physical function(P<0.001) and spinal mobility(P<0.001). They were more anxious(P<0.001), depressed(P<0.001) and had more sleep disturbance(P=0.001). Compared with active AS patients, stable AS patients had more leukocytes(P=0.040), lymphocytes(P=0.002), erythrocytes(P=0.001) and hemoglobin(P<0.001). Active disease activity had a significant impact on all dimensions of quality of life in AS patients(P<0.001).Conclusion:These findings suggested that medical personnel should pay more attention to active AS patients and make effective interventions to improve quality of life.References:[1]Exarchou S, Lindstrom U, Askling J, Eriksson JK, Forsblad-d’Elia H, Neovius M, Turesson C, Kristensen LE, Jacobsson LT (2015) The prevalence of clinically diagnosed ankylosing spondylitis and its clinical manifestations: a nationwide register study. Arthritis research & therapy 17:118. doi:10.1186/s13075-015-0627-0[2]Qian Q, Xu X, He H, Ji H, Zhang H, Ding Y, Dai SM, Zou Y, Zhu Q, Yang C, Ye S, Jiang L, Tang JP, Tong Q, He D, Zhao D, Li Y, Ma Y, Zhou J, Yuan Z, Zhang J, Jin L, Zhou X, Reveille JD, Zou H, Wang J (2017) Clinical patterns and characteristics of ankylosing spondylitis in China. Clinical rheumatology 36 (7):1561-1568. doi:10.1007/s10067-017-3660-3[3]Huang JC, Qian BP, Qiu Y, Wang B, Yu Y, Zhu ZZ, Hu J, Qu Z (2017) Quality of life and correlation with clinical and radiographic variables in patients with ankylosing spondylitis: a retrospective case series study. BMC musculoskeletal disorders 18 (1):352. doi:10.1186/s12891-017-1711-1Acknowledgments:Thanks to all the authors for their efforts and thanks to all members of the Department of Rheumatology of Affiliated Hospital of Nantong University for their helpfulness in the acquisition of data.Disclosure of Interests:None declared
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50

Farisoğullari, B., G. K. Yardimci, E. C. Bolek, E. Bilgin, E. Duran, G. Ayan, Z. Özsoy, et al. "POS0931 RETENTION RATE AND TREATMENT RESPONSE OF BIOLOGICAL AGENTS IN ADVANCED SPINAL ANKYLOSIS AND BAMBOO SPINE: THE REAL LIFE DATA FROM THE HUR-BIO REGISTRY." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 728.2–729. http://dx.doi.org/10.1136/annrheumdis-2021-eular.2468.

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Background:Axial spondyloarthritis (axSpA) may lead to linear radiographic progression and progress to advanced spinal disease and finally to the bamboo spine (1).Objectives:To assess the demographic, clinical, disease activity and retention rates of patients using biological disease-modifying antirheumatic drugs (bDMARD) with advanced spinal disease and bamboo spine in the Hacettepe University Rheumatology Biologic Registry (HUR-BIO) cohort.Methods:In the HUR-BIO spondyloarthritis (SpA) registry were available 2952 patients. Of these, 774 patients with lumbar and cervical radiographs were included in the study. Advanced spinal ankyloses (99 patients) was defined as the presence of at least two intervertebral adjacent bridges at the lumbar and/or cervical spine level without bamboo spine. Bamboo spine (78 patients) was defined with a complete fusion of all lumbar and cervical spines. In addition, patients who diagnosed with axSpA for at least 10 years but no develop syndesmophytes on lumbar and cervical spine (92 patients) were used as a control group.Results:Both the bamboo spine and advanced spinal disease had higher age, higher BMI, more smoking (ever) and hip involvement compared to the without syndesmophytes group. Acute phase reactants, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Ankylosing spondylitis disease activity Score-CRP (ASDAS-CRP) parameters were similar at the beginning of bDMARD in all groups. BASFI was higher in the bamboo spine group than in the without syndesmophytes group at last visit (Table 1). There were no differences between all groups in terms of the retention rate of the first bDMARD (Log rank p=0.86) (Figure 1).Conclusion:Data on the use of bDMARDs in SpA patients with bamboo spine are limited. This study showed that bDMARDs are an effective treatment option in SpA patients with bamboo spine with high disease activity. Similar drug retention rates were found compared to SpA patients with no syndesmophytes. Although the disease activity decreased similar rates in the groups, functional limitation continued in approximately half of the patients in bamboo spine patients.References:[1]Braun J et al. Staging of patients with ankylosing spondylitis: a preliminary proposal. Annals of the rheumatic diseases, 2002, 61.suppl 3: iii19-iii23.Table 1.Demographic, clinical characteristics and response to treatment in SpA groups.Without syndesmophytesn= 92Advanced spinal diseasen= 99Bamboo spinen= 78pAge, years˚42.2 ± 8.851.3 ± 10.255.5 ± 9.3< 0.001*Age at disease onset, years˜25.01 (11)36.6 (20)33.3 (18)< 0.001*Male, n (%)55 (59.8)78 (78.8)66 (84.6)< 0.001*Disease duration, years˜13.8 (5)12.3 (15)17.6 (13)< 0.001*Delay in diagnosis, months˜12.02 (43)36.01 (89)36.01 (100)0.013*HLA-B27 positivity/total, n (%)21/42 (50)31/45 (69)16/28 (57)0.19BMI˜26.3 (8)29.7 (7)29.4 (7)< 0.001*Smoking (ever), n (%)56 (61)78 (79)58 (74)0.019*Hip involvement, positivity/total (%)11/84 (13.1)34/86 (39.5)37/75 (49.3)< 0.001*OnsetLastOnsetLastOnsetLastp (onset)p (last)ESR, mm/h˜21.5 (34)12.5 (18)25.5 (29)14.5 (17)23 (31)14 (14)0.60.59CRP, mg/dL˜1.5 (4)0.4 (0.6)1.7 (2)0.65 (1)1.8 (3)0.64 (0.8)0.40.001*ASDAS-CRP˜3.6 (0.8)1.9 (1)3.4 (0.9)2 (1.2)3.4 (0.8)1.9 (1.4)0.40.23BASDAI score˜5.7 (2.6)2.4 (4.5)5.6 (3.3)2.8 (3.1)5.6 (3.2)2.4 (3.3)10.31BASFI score˜5.4 (4)2 (4)4.5 (4)3 (4)6.5 (3)3.9 (4.5)0.10.002*BASFI score > 4, n (%)29 (59)23 (25)29 (56)32 (32)27 (75)36 (46)0.10.014*ASAS PR, n (%)26 (28)15 (15)17 (22)0.09*p <0.05, ˚mean ± SD, ˜median (IQR) SD: Standard deviation; IQR: Inter-quartile range BASDAI: Bath Ankylosing Spondylitis Disease Activity Index; BASFI: Bath Ankylosing Spondylitis Functional Index; BMI: Body mass index; ESR: Erythrocyte sedimentation rate; CRP: C-reactive protein; ASAS PR: Assessment in SpondyloArthritis International Society partial remission; ASDAS: Ankylosing spondylitis disease activity scoreFigure 1.Retention rate of the first bDMARDDisclosure of Interests:None declared
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