ABSTRACT
From a retrospective analysis (1980-1984) we found 32 cases of chronic Reiter's syndrome with spinal involvement on the radiographs (as sacroiliitis, parasyndesmophytes, and rarely syndesmophytes). In these 32 case histories spinal pain was a rather frequent symptom, often beginning with the onset of the disease, whereas severe functional spinal impairment was seldom found. Joints were only mildly affected, organic symptoms were found chiefly in clinical history, but were often incomplete. Trigger infections were known in 40%, and 87% of the patients were HLA B27 positive. These 32 patients with mainly spinal symptoms represent 75% of all cases (n = 43) suffering from chronic Reiter's syndrome within the period of observation. Previous observations as well as our experience point to the fact that the chronic course of disease in Reiter's syndrome mainly affects the spinal structure with comparatively mild clinical symptoms.
Subject(s)
Arthritis, Reactive/diagnosis , Spinal Diseases/diagnosis , Adult , Chronic Disease , Female , Humans , Male , Middle Aged , Sacroiliac Joint , Spondylitis, Ankylosing/diagnosisABSTRACT
In a retrospective study 10 cases (6 males, 4 females) of special disco-vertebral forms of ankylosing spondylitis were evaluated. In all cases radiographs showed bilateral sacroiliitis and destructive-sclerotic disco-vertebral lesions but hardly any syndesmophytes considered typical for ankylosing spondylitis. We found a rather striking diversity of morphologic changes caused by spondylodiscitis, polysegmental involvement, the simultaneous and successive appearance (in the cause of the disease) of shiny corner, as well as anterior spondylitis and spondylodiscitis. All cases had clinical and humoral signs of disease activity, and some even had extravertebral manifestations. Radiographs and clinical findings indicate that an inflammatory process causes the disco-vertebral lesions. The special forms of ankylosing spondylitis as described in this article are in accordance with the polymorphism frequently observed in this disease.
