Magnetic resonance imaging evaluation of shoulder joint in patients with early stage of ankylosing spondylitis: A case-control study.

PURPOSE: The goal of this prospective study was to determine the prevalence of shoulder abnormalities on magnetic resonance imaging (MRI) in patients with ankylosing spondylitis (AS) who have normal shoulder X-ray examinations and no clinical shoulder abnormalities using a case-control study. MATERIALS AND METHODS: Fifty-three patients with AS according to the SpondyloArthritis international Society (ASAS) criteria were enrolled in the study. Fifty-three patients with no AS served as control subjects. Shoulder MRI examinations of patients in the two groups were analyzed and results were compared. RESULTS: In the patient group, 26/53 patients (49.1%) demonstrated one or two of the defined pathological shoulder MRI findings, whereas 5/53 patients (9.4%) had similar findings in the control group. In the patient group, 11/53 patients (20.8%) had enthesal bone marrow edema, 19/53 patients (35.8%) had increased synovial fluid, 8/53 patients (15.1%) had tendinitis, and 2/53 patients (3.8%) had bursitis. There was statistically significant difference between the patient and control groups in terms of prevalence of enthesal bone marrow edema, increase in synovial fluid, and tendinitis. CONCLUSION: Shoulder involvement is often overlooked in AS. Knowledge of the early-stage findings of the shoulder involvement due to AS is important to establish an early diagnosis and select treatment options.

The effect of infliximab on depressive symptoms in patients with ankylosing spondylitis.

UNLABELLED:

OBJECTIVES: Ankylosing spondylitis is a chronic inflammatory disease which physically, psychologically, and socially affects the patient's life. Previous studies have reported a correlation between ankylosing spondylitis and depression. In this study we investigated the effect of infliximab on depression in ankylosing spondylitis patients. METHODS: A total of 29 patients with ankylosing spondylitis were enrolled in this prospective study. Infliximab was administered intravenously at a dose of 5 mg/kg at baseline, weeks 2 and 6. The measurements of morning stiffness, modified Schober's test, chest expansion, erythrocyte sedimentation rate, C-reactive protein, Bath ankylosing spondylitis disease activity index, Bath ankylosing spondylitis functional index and Beck depression inventory scores were compared with baseline and 12th week. RESULTS: The modified Schober's test and chest expansion increased, the morning stiffness duration, erythrocyte sedimentation rate and C-reactive protein levels decreased after infliximab treatment (p < 0.001, respectively). There was statistically significant decrease in Bath ankylosing spondylitis disease activity index, Bath ankylosing spondylitis functional index and Beck depression invantory scores of patients after 12 weeks (p < 0.001, respectively). CONCLUSION: Infliximab can improve depression and its symptoms in patients with ankylosing spondylitis.