1/39. "Ankylosing spondylitis" without sacroiliitis in a woman without the HLA B27 antigen.An elderly woman with otherwise typical ankylosing spondylitis for 45 years lacked radiologic evidence of sacroiliitis and the HLA B27 antigen. The illness was complicated by renal tuberculosis requiring a left nephrectomy 23 years after the onset of low back pain, and 20 years after an episode of severe iritis. After the eradication of the tuberculosis by surgery and chemotherapy, she has continued to have symptomatic spondylitis. The case seems to be an exception to the rule that sacroiliitis is a sine qua non for ankylosing spondylitis. women with ankylosing spondylitis tend to have milder disease with an apparently lower frequency of roentgenographic changes in sacroiliac joints.- - - - - - - - - - ranking = 1keywords = sacroiliitis (Clic here for more details about this article) |
2/39. sacroiliitis - it's not all B 27.We describe an HLA-B27 positive patient in whom posttraumatic pyogenic sacroiliitis led to complete unilateral sacroiliac joint ankylosis in the absence of any signs indicative of HLA-B27 associated spondyloarthropathy. sacroiliitis is the pathologic hallmark - and usually one of the earliest pathologic manifestations - of ankylosing spondylitis (AS). Bilateral sacroiliitis is typical for ankylosing spondylitis. The frequency of asymmetric sacroiliitis may be higher in other inflammatory disorders, e.g., reactive arthritis, Reiters syndrome, spondylitis associated with psoriasis, or inflammatory bowel disease. Most but not all of these disorders show an increased prevalence among individuals who have inherited the HLA-B27 gene. In the context of this case, we discuss the differential diagnosis of unilateral sacroiliitis.- - - - - - - - - - ranking = 0.66666666666667keywords = sacroiliitis (Clic here for more details about this article) |
3/39. A case of coexisting Behcet's disease and ankylosing spondylitis.Behcet's disease (BD) is a chronic inflammatory condition involving several organs, such as skin, mucous membrane, eye, joint, intestine, lung and central nervous system. Ankylosing spondylitis (AS) is a prototype of seronegative spondyloarthropathy, and a chronic systemic inflammatory disorder of the axial skeleton, mainly affecting the sacroiliac joint and spine. In the latter, systemic complications may develop in addition to joint involvement. The coexistence of BD and AS has been rarely reported in the literature. The inclusion of BD among seronegative spondyloarthritides and whether sacroiliitis (SI) develops in BD are still being debated. We describe a 28-year-old man who has fulfilled the diagnostic criteria for BD and AS as well.- - - - - - - - - - ranking = 0.16666666666667keywords = sacroiliitis (Clic here for more details about this article) |
4/39. First manifestations of seronegative spondylarthropathy following autologous stem cell transplantation in HLA-B27-positive patients.Two male patients with non-Hodgkin's lymphoma (NHL, follicular NHL, diffuse large B cell NHL, both in 2nd complete remission) and one female patient with acute myeloid leukemia in 1st complete remission developed arthralgias and enthesopathy following autologous stem cell transplantation. In 2/3 patients, sacroiliitis could be demonstrated on X-ray. In both patients, the rheumatic symptoms were classified as manifestations of a spondylarthropathy. All three patients were subsequently shown to be HLA-B27-positive. The patients were successfully treated with non-steroidal anti-inflammatory drugs. The differential diagnosis of joint pain following autologous stem cell transplantation should include HLA-B27-associated spondylarthropathies in addition to the more commonly seen bone and joint pain due to immobilization and medication.- - - - - - - - - - ranking = 0.16666666666667keywords = sacroiliitis (Clic here for more details about this article) |
5/39. A controlled study of sacroiliitis in Behcet's disease.The aim of the study was to evaluate the prevalence of sacroiliitis in a group of patients with Behcet's disease (BD). Pelvic x-rays of 27 patients with BD responding to the International Study Group of BD and 30 controls (15 AS and 15 sciatica) were read blind and sacroiliac involvement was graded according to the new york criteria. In a second step, patients or controls with equivocal sacroiliitis had a sacroiliac CT scan. Two patients with BD (7.4%) and all patients with AS had evident bilateral sacroiliitis (at least grade 2). One patient with BD and two patients with sciatica had equivocal sacroiliitis (grade 1). CT confirmed sacroiliitis in the two patients with BD and eliminated inflammatory sacroiliitis in the three other patients with equivocal sacroiliitis showing mild degenerative lesions. A review of the literature showed that sacroiliitis and AS are rarely associated with BD. There remains insufficient evidence to suggest that sacroiliitis is an intrinsic feature of BD and that BD belongs to the group of SpA.- - - - - - - - - - ranking = 2.1666666666667keywords = sacroiliitis (Clic here for more details about this article) |
6/39. Destructive diskovertebral lesions in ankylosing spondylitis: appearance on magnetic resonance imaging.We report magnetic resonance imaging findings of diskovertebral lesions in a case of ankylosing spondylitis mimicking metastatic and/or infectious disease. Multiple hypointense areas were seen on T1-weighted images corresponding to hyperintense areas on T2-weighted images in dorsal, lumbar, and sacral vertebral bodies and the manubriosternal joint, with accompanying soft tissue masses. diagnosis was achieved through biopsy, regression of the paravertebral soft tissue masses, later detection of bilateral sacroiliitis on computed tomography, and presence of histocompatibility antigen HLA-B27.- - - - - - - - - - ranking = 0.16666666666667keywords = sacroiliitis (Clic here for more details about this article) |
7/39. Possible use of arthrodesis for intractable sacroiliitis in spondylarthropathy: report of two cases.STUDY DESIGN: Two cases of successful sacroiliac joint arthrodesis for medically intractable aseptic sacroiliitis are reported. SUMMARY OF BACKGROUND DATA: Although successful arthrodesis of the sacroiliac joint had been reported previously for septic sacroiliitis, no report had shown the procedure to be effective for spondylarthropathy. methods: Two women with spondylarthropathy involving very painful sacroiliac arthritis for 18 and 24 months had been relieved only transiently by several injections of steroids into the sacroiliac joint under fluoroscopy and by bermuda casts. Both patients underwent sacroiliac joint arthrodesis. RESULTS: Both patients showed dramatic improvement after sacroiliac joint arthrodesis. Moreover, no relapses had occurred, respectively, after 2 and 3 years of follow-up evaluation despite continuing spondylarthropathy in other joints. CONCLUSIONS: After a careful selection of patients, including positive blocks in the sacroiliac joint, arthrodesis of sacroiliac joint might be considered for so-called "intractable" aseptic sacroiliitis.- - - - - - - - - - ranking = 1.1666666666667keywords = sacroiliitis (Clic here for more details about this article) |
8/39. HLA-B27 positive juvenile arthritis with cardiac involvement preceding sacroiliac joint changes.While cardiovascular disease develops in up to 50% of adult patients with ankylosing spondylitis, it is very uncommon in its juvenile counterpart. Regarding the early stage of the disease, before onset of sacroiliac joint changes, only two cases with aortic incompetence have been published while reports of mitral valve involvement are not available. A 13 year old boy is described with an HLA-B27 positive asymmetric oligoarthritis and enthesitis, without back pain or radiographic evidence of sacroiliitis. echocardiography showed an echogenic structure measuring 8 x 11 x 20 mm at the fibrous continuity between the aortic and mitral valves extending through a false tendon into an echogenic thickened posterior papillary muscle, causing a grade II aortic and grade I/II mitral regurgitation. Short term corticosteroid and long term non-steroidal anti-inflammatory drug and disease modifying antirheumatic drug treatments efficiently controlled the symptoms. The cardiac findings remained unchanged during a follow up of 20 months. Careful cardiac evaluation appears to be mandatory even in these young patients.- - - - - - - - - - ranking = 0.16666666666667keywords = sacroiliitis (Clic here for more details about this article) |
9/39. Clinics in diagnostic imaging (70). Bilateral sacroiliitis due to ankylosing spondylitis.A 15-year-old boy was incidentally found to have bilateral sacroiliitis. Radiographs showed erosions and subchondral sclerosis of both sacroiliac joints. His ESR was raised and HLA-B27 was positive. Presumptive diagnosis was ankylosing spondylitis. The clinical and imaging features, including the radiographical classification, of sacroiliitis are discussed. knowledge of the patterns of distribution and correlation with clinical manifestations aid in differentiating among the various causes of sacroiliitis.- - - - - - - - - - ranking = 1.1666666666667keywords = sacroiliitis (Clic here for more details about this article) |
10/39. Ankylosing spondylitis: a difficult diagnosis in patients on long-term renal replacement therapy.We report the case of a 48-year-old male, whose musculoskeletal manifestations, previously related to long-term renal replacement therapy (RRT), were diagnosed as ankylosing spondylitis when symptoms changed their pattern on daily hemodialysis (DHD). The patient started RRT in 1981; in 1985 he received a cadaver graft, which failed in 1987. Secondary hyperparathyroidism, amyloid geoids, bilateral carpal tunnel syndrome and high aluminium levels were present. musculoskeletal pain, reported since 1986, involved feet, heels, hips, shoulders, hands, spine. Symptoms impairing daily life did not improve after parathyroidectomy. He developed chronic hypotension and recurrent atrial fibrillation. In 1994 and 1998, because of thoracic pain, coronarography was performed (normal on both occasions). In June 2000, DHD was started. Equivalent renal clearance increased from 9-12 to 15-17 mL/min. Well-being remarkably improved. In September 2000, musculoskeletal pain worsened and bilateral Achilles tendinitis occurred. The worsening of musculoskeletal symptoms despite the improvements in well-being and other dialysis related symptoms prompted a re-evaluation of the case. The diagnosis of ankylosing spondylitis was based on: history of plantar fasciitis, bilateral Achilles tendinitis, inflammatory spinal pain with limitation of lumbar spine mobility (positive Schober test), radiological evidence of grade 2 bilateral sacroiliitis, presence of HLA-B27. This diagnosis cast light on the episodes of chest pain, explained by enthesopathy at the costosternal and manubriosternal joints and atrial fibrillation, due to HLA-B27 associated impairment in heart conduction. This case exemplifies the difficulty of differential diagnosis of multisystem illness in patients with long RRT follow-up.- - - - - - - - - - ranking = 0.16666666666667keywords = sacroiliitis (Clic here for more details about this article) |
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