No abstract available.
Spondylarthropathies* ; Spondylitis, Ankylosing*

OBJECTIVE: This study examined the all-cause and sex-specific standardized mortality ratios (SMRs) in patients with spondyloarthropathy. METHODS: Studies examining the all-cause and/or cause-specific SMRs in patients with psoriatic arthritis (PsA) and ankylosing spondylitis (AS) compared to the general population were surveyed using MEDLINE, EMBASE, and Cochrane databases and manual searches. A meta-analysis of the all-cause and sex-specific SMRs in patients with rheumatic diseases was then performed. RESULTS: In total, 7 comparisons (5 PsA and 2 AS) from 6 reports met the inclusion criteria. Disease-specific meta-analysis showed that the pooled SMR was 1.299 (95% confidence interval [CI] 1.092–1.605, p=0.015) for PsA and 1.784 (95% CI 1.576–2.020, p < 0.001) for AS. Meta-analysis showed that the SMRs of PsA and AS were significantly higher (1.299 to 1.784 times) than those in the general population. The age- and sex-adjusted SMR was highest for AS (1.784), followed by PsA (1.299). Moreover, sex-specific meta-analysis showed that the all-cause SMRs were increased in female and male patients with PsA. On the other hand, mortality increased in male patients with AS (SMR 1.834), whereas there was no significant increase in female patients with AS. CONCLUSION: All-cause mortality is higher in patients with PsA and AS compared to the general population. On the other hand, the mortality was higher in males with AS but not in females.
Arthritis, Psoriatic* ; Female ; Hand ; Humans ; Male ; Mortality* ; Rheumatic Diseases ; Spondylarthropathies ; Spondylitis, Ankylosing*

Magnetic resonance imaging (MRI) is a highly reliable tool for diagnosing ankylosing spondylitis. MRI can identify cartilage abnormalities, subcortical erosions, bone marrow edema with inflammation, and synovial enhancement. Subchondral sclerosis and juxta-articular fat deposition are noted in the chronic stage of ankylosing spondylitis. Spinal changes associated with spondyloarthropathy are florid anterior spondylitis (or Romanus lesion), florid diskitis (Anderson lesion), ankylosis, and arthritis of the apophyseal and costovertebral joints. A MRI grading system for inflammation in sacroiliac joints and the spine could help clinicians evaluate the anti-inflammatory efficacy of therapeutics. Newer technologies based on MRI are aimed at broadening the diagnostic scope and facilitating the quantification of active inflammation but still require extensive validation.
Ankylosis ; Arthritis ; Bone Marrow ; Cartilage ; Discitis ; Edema ; Inflammation ; Joints ; Magnetic Resonance Imaging ; Sacroiliac Joint ; Sacroiliitis ; Sclerosis ; Spine ; Spondylarthropathies ; Spondylitis ; Spondylitis, Ankylosing

In ankylosing spondylitis the mainstay of therapy is to prevent deformity by relieving pain with medicine and by exetcise. But once the deformity is fixed in a bad postrue surgical correction is the only way to make the patient feel comfortable. The purpose of this paper is to discuss on the surgical treatment of spinal deformity, spondylodiscitis and spine fractures in ankylosing spondylitis with some illustrative cases presentation.
Congenital Abnormalities* ; Discitis ; Humans ; Spine ; Spondylitis, Ankylosing*

Reiter's syndrome is associated with a classic triad of arthritis, conjunctivitis, urethritis, and is the most common type of reactive arthritis. This syndrome is a one type of seronegative arthropathy, requiring differential diagnosis with psoriatic arthritis and ankylosing spondylitis, since it is associated with psoriasis-like skin lesion, sacroilitis, spondylitis. The arthritis of Reiter's syndrome is known to be acute, short-lived, and transient, but with subsequent attacks, it is more likely that it will lead to permanent joint damage or disability. We recently have experienced one case of Reiter's syndrome with severe joint destruction and significant functional disability, so here we report one case with review of literature.
Arthritis ; Arthritis, Psoriatic ; Arthritis, Reactive ; Conjunctivitis ; Diagnosis, Differential ; Joints* ; Skin ; Spondylitis ; Spondylitis, Ankylosing ; Urethritis

BACKGROUND: HLA-B27 is associated with an increased incidence of specific spondyloarthropathies(SpA), most notably ankylosing spondylitis(AS). I evaluated the cases referred for HLA-B27 antigen using flowcytometry (FCM) to find the clinical characteristics of the patients and the diagnostic utilities of median fluorescence intensity (MFI) in HLA-B27 program. METHODS: I evaluated 443 subjects of HLA-B27 cases using FACScan flowcytometry, consisted with software for automated calibration and analysis, calibration beads, and the anti-HLA- B27 fluorescein isothiocyanate (FITC)/anti-CD3 phycoerythrin (PE) monoclonal antibodies (all from Becton Dickinson, San Jose, CA). RESULTS: Of the total 443 cases, the positive rate in male cases was 44% (132/300) and it was higher than that of female cases (22.4%, 32/143). The gating procedure was failed in one sample of 443 (0.23%). The positive rates in each diagnostic criteria were as follows; AS 61.6%, gout 20.0%, herniated intervertebral disc 20%, lower back pain 25.6%, polyarthritis 16.0%, psoriatic arthritis 20.0%, rheumatoid arthritis 28.3%, reactive arthritis 26.9%, SpA, undifferentiated 31.8% and uveitis/iritis 23.8%. In AS group, 89 cases (95.7%) showed MFI values higher than 150. CONCLUSION: About 62% of AS group showed HLA-B27 positivity using FCM and the positive rates of other diseases group in SpA categories were around 20-30%. If we considered MFI value 150 as differential value, about 95% of HLA-B27 positive AS cases might not need further confirmatory study to differentiate HLA-B7.
Antibodies, Monoclonal ; Arthritis ; Arthritis, Psoriatic ; Arthritis, Reactive ; Arthritis, Rheumatoid ; Calibration ; Female ; Fluorescein ; Fluorescence ; Gout ; HLA-B27 Antigen* ; HLA-B7 Antigen ; Humans ; Incidence ; Intervertebral Disc ; Low Back Pain ; Male ; Phycoerythrin ; Spondylarthropathies ; Spondylitis, Ankylosing

The hallmark of ankylosing spondylitis (AS) is acute and chronic spinal inflammation initiating in the sacroiliac joints, often coupled with enthesitis, presenting as chronic inflammation at the sites of ligamentous and tendinous insertions into bone. Peripheral joint synovitis can be a prominent feature as well. Reactive arthritis (ReA) is a sterile synovitis arising after enteric or urogential tract infections. A great progression has been recently achieved in revealing the causes, and making plans for the treatments for AS and other types of spondyloarthropathy. The human leukocyte antigen (HLA)-B27 has been well known to be associated with disease susceptibility in AS and ReA. But the pathogenesis of AS and ReA is still not well defined. Although the clinical manifestations of AS and ReA may differ, in this review we discuss the two diseases together and focus on recent developments on the pathogenesis of both diseases.
Arthritis, Reactive ; Disease Susceptibility ; HLA-B27 Antigen ; Humans ; Inflammation ; Joints ; Leukocytes ; Ligaments ; Sacroiliac Joint ; Spondylarthropathies ; Spondylitis, Ankylosing* ; Synovitis

The spondyloarthropathies are a group of inflammatory rheumatic diseases including ankylosing spondylitis, reactive arthritis, psoriatic arthritis, arthritis associated with inflammatory bowel disease, and undifferentiated spondyloarthropathy. It usually begins in young or middle aged adults, but sometimes presents with atypical symptoms in the older patients. Late onset spondyloarthropathies are characterized by severe disease, marked elevation of laboratory parameters of inflammation, oligoarthritis involving the lower limbs with edema of the extremities. We described a 66-year-old patient who presented with asymmetric polyarthritis mainly involving lower extremities with fever, marked elevation of laboratory inflammatory markers, and was successfully treated with mini-pulse corticosteroids with disease modifying antirheumatic drugs.
Adrenal Cortex Hormones ; Adult ; Aged ; Antirheumatic Agents ; Arthritis ; Arthritis, Psoriatic ; Arthritis, Reactive ; Edema ; Extremities ; Fever ; Humans ; Inflammation ; Inflammatory Bowel Diseases ; Lower Extremity ; Middle Aged ; Rheumatic Diseases ; Spondylarthropathies* ; Spondylitis, Ankylosing

No abstract available.
Spondylitis, Ankylosing*

No abstract available.
Spondylitis, Ankylosing