Macrovascular and microvascular type 2 diabetes complications are interrelated in a mouse model.

AIM: Evaluate the development of multiple complications, their interactions, and common mechanisms in the same individual with T2D. MATERIAL AND METHODS: 4-week-old male C57BL/6J mice were divided into: control (n = 6) and T2D (n = 6). T2D was induced through a high-carbohydrate-diet and low doses of streptozotocin. T2D was validated by metabolic parameters. Diabetic neuropathy was evaluated by mechanical and thermal sensitivity tests. We performed a histopathological analysis of the heart, kidney, liver, and parotid salivary glands and changes in bone microarchitecture by µCT. We calculated the relative risk (RR), odd ratios (OR) and Pearson correlation coefficients between the different complications and metabolic features. RESULTS: T2D mice have cardiomyopathy, neuropathy, nephropathy, liver steatosis and fibrosis, structural damage in parotid salivary glands, and bone porosity. RR analysis shows that all complications are interrelated by hyperglycaemia, insulin resistance, obesity, and systemic inflammation. CONCLUSIONS: T2D mice develop multiple complications simultaneously, which are related to each other, and this is associated with metabolic alterations. Our findings open up new approaches for the study and new therapeutic approaches of the pathophysiology of T2D and its complications.

[Medial Hoffa fracture: a case report]. / Fractura de Hoffa medial: reporte de un caso.

INTRODUCTION: knee femoral condyle coronal fractures or Hoffa fractures are among the rarest fractures of the pelvic limb, being even more rare those of the medial condyle. The success in the management of these patients lies in the timely diagnosis and the consequent anatomical reduction of the femoral articular surface. CLINICAL CASE: the objective of this article is to present a patient with right medial Hoffa fracture, registered as a single case in the archives of our hospital. The patient was referred to us on November 2011, with a 10-day course after suffering a fall from horse ridding, presenting a forced varus mechanism and direct contusion of the right knee. He shows an anteroposterior and lateral knee X-rays showing a subtle solution of continuity in the coronal plane of the base of the medial condyle, corroborated with magnetic resonance imaging and was also associated with a non-surgical partial injury of both menisci and the anterior cruciate ligament. Surgical intervention was performed on 27th/11/2011, through open reduction with a medial approach and internal fixation with 7.0 mm (x2) cannulated screws. The patient was discharged with early and continuous mobilization of the knee, deferring support and rehabilitation until the 6th week. He is currently a wandering patient, asymptomatic, with complete range of motion. Because respecting the extensor apparatus through a medial approach and the articular surface with cannulated screws, it was observed in consequence an adequate evolution of our patient, being able to return to his daily activities, even remount.

INTRODUCCIÓN: las fracturas del cóndilo femoral en el plano coronal o fracturas de Hoffa se encuentran entre las fracturas más raras del miembro pélvico, pero son aún más raras las del cóndilo medial. El éxito en el manejo de estos pacientes radica en el diagnóstico oportuno y la consecuente reducción anatómica de la superficie articular del fémur. CASO CLÍNICO: el objetivo de este reporte es presentar a un paciente con el diagnóstico de fractura de Hoffa medial derecha, registrado como caso único en los archivos de nuestro hospital. El paciente acudió referido en Noviembre de 2011, con evolución de 10 días tras sufrir caída de caballo, presentando mecanismo de varo forzado y contusión directa de la rodilla derecha. Mostró radiografías anteroposterior y lateral de rodilla derecha, donde se observó de forma sutil solución de la continuidad en el plano coronal de la base del cóndilo medial, corroborado por resonancia magnética y asociado a lesiones parciales no quirúrgicas de ambos meniscos y del ligamento cruzado anterior. Se intervino quirúrgicamente el día 27 de Noviembre de 2011 mediante reducción abierta con abordaje medial y fijación interna con dos tornillos canulados de 7.0 mm. Se egresó al paciente indicando la movilización temprana y continua de la rodilla, difiriendo el apoyo y rehabilitación hasta la sexta semana. Actualmente el paciente se encuentra con posibilidad de deambulación, asintomático y con arcos de movilidad completos. El respeto del aparato extensor mediante un abordaje medial y la superficie articular con tornillos canulados se refleja en la adecuada evolución de nuestro paciente, pudiendo regresar a sus actividades diarias, incluso el montar.

Matrix Metalloproteinases and Stress Hormones in Lung Cancer Progression.

Several matrix metalloproteinases (MMPs) and psychological stress are associated with poor cancer prognosis. The current work goal was to determine MMPs' and stress hormones' blood concentrations from lung adenocarcinoma (LAC) patients. Patients were divided into the following groups: tobacco smokers (TS), wood smoke-exposed (W), passive smokers (PS), TS exposed to wood smoke (TW), and patients with no recognizable risk factor (N). MMPs, tissue inhibitors of metalloproteinases (TIMPs), adrenaline, noradrenaline, and cortisol blood concentrations were measured by ELISA. Zymography and Western blot assays were performed to determine MMP-2 and MMP-9 active and latent forms. MMP-2, MMP-3, MMP-9, and TIMP-1 blood concentrations, and MMP-9 gelatinase activity were augmented, while MMP-12, MMP-14, and TIMP-2 were diminished in LAC patients. Cortisol was increased in LAC samples. Adrenaline concentrations were higher in W, TS, and TW, and noradrenaline was increased in W and N groups. Positive correlations were observed among cortisol and TIMP-1 (r s = 0.392) and TIMP-2 (r s = 0.409) in the W group and between noradrenaline and MMP-2 (r s = 0.391) in the N group. MMPs' blood concentration increments can be considered as lung cancer progression markers. Although stress hormones were also augmented, only weak correlations were observed between them and MMPs and TIMPs.

Nanotechnology and Matrix Metalloproteinases in Cancer Diagnosis and Treatment.

Cancer is still one of the leading causes of death worldwide. This great mortality is due to its late diagnosis when the disease is already at advanced stages. Although the efforts made to develop more effective treatments, around 90% of cancer deaths are due to metastasis that confers a systemic character to the disease. Likewise, matrix metalloproteinases (MMPs) are endopeptidases that participate in all the events of the metastatic process. MMPs' augmented concentrations and an increased enzymatic activity have been considered bad prognosis markers of the disease. Therefore, synthetic inhibitors have been created to block MMPs' enzymatic activity. However, they have been ineffective in addition to causing considerable side effects. On the other hand, nanotechnology offers the opportunity to formulate therapeutic agents that can act directly on a target cell, avoiding side effects and improving the diagnosis, follow-up, and treatment of cancer. The goal of the present review is to discuss novel nanotechnological strategies in which MMPs are used with theranostic purposes and as therapeutic targets to control cancer progression.

Fractura de Hoffa medial: reporte de un caso / Medial Hoffa fracture: a case report

Resumen: Introducción: Las fracturas del cóndilo femoral en el plano coronal o fracturas de Hoffa se encuentran entre las fracturas más raras del miembro pélvico, pero son aún más raras las del cóndilo medial. El éxito en el manejo de estos pacientes radica en el diagnóstico oportuno y la consecuente reducción anatómica de la superficie articular del fémur. Caso clínico: El objetivo de este reporte es presentar a un paciente con el diagnóstico de fractura de Hoffa medial derecha, registrado como caso único en los archivos de nuestro hospital. El paciente acudió referido en Noviembre de 2011, con evolución de 10 días tras sufrir caída de caballo, presentando mecanismo de varo forzado y contusión directa de la rodilla derecha. Mostró radiografías anteroposterior y lateral de rodilla derecha, donde se observó de forma sutil solución de la continuidad en el plano coronal de la base del cóndilo medial, corroborado por resonancia magnética y asociado a lesiones parciales no quirúrgicas de ambos meniscos y del ligamento cruzado anterior. Se intervino quirúrgicamente el día 27 de Noviembre de 2011 mediante reducción abierta con abordaje medial y fijación interna con dos tornillos canulados de 7.0 mm. Se egresó al paciente indicando la movilización temprana y continua de la rodilla, difiriendo el apoyo y rehabilitación hasta la sexta semana. Actualmente el paciente se encuentra con posibilidad de deambulación, asintomático y con arcos de movilidad completos. El respeto del aparato extensor mediante un abordaje medial y la superficie articular con tornillos canulados se refleja en la adecuada evolución de nuestro paciente, pudiendo regresar a sus actividades diarias, incluso el montar.

Abstract: Introduction: Knee femoral condyle coronal fractures or Hoffa fractures are among the rarest fractures of the pelvic limb, being even more rare those of the medial condyle. The success in the management of these patients lies in the timely diagnosis and the consequent anatomical reduction of the femoral articular surface. Clinical case: The objective of this article is to present a patient with right medial Hoffa fracture, registered as a single case in the archives of our hospital. The patient was referred to us on November 2011, with a 10-day course after suffering a fall from horse ridding, presenting a forced varus mechanism and direct contusion of the right knee. He shows an anteroposterior and lateral knee X-rays showing a subtle solution of continuity in the coronal plane of the base of the medial condyle, corroborated with magnetic resonance imaging and was also associated with a non-surgical partial injury of both menisci and the anterior cruciate ligament. Surgical intervention was performed on 27th/11/2011, through open reduction with a medial approach and internal fixation with 7.0 mm (x2) cannulated screws. The patient was discharged with early and continuous mobilization of the knee, deferring support and rehabilitation until the 6th week. He is currently a wandering patient, asymptomatic, with complete range of motion. Because respecting the extensor apparatus through a medial approach and the articular surface with cannulated screws, it was observed in consequence an adequate evolution of our patient, being able to return to his daily activities, even remount.

Matrix Metalloproteinases' Role in Tumor Microenvironment.

Cancer cells evolve in the tumor microenvironment (TME) by the acquisition of characteristics that allow them to initiate their passage through a series of events that constitute the metastatic cascade. For this purpose, tumor cells maintain a crosstalk with TME non-neoplastic cells transforming them into their allies. "Corrupted" cells such as cancer-associated fibroblasts (CAFs), tumor-associated macrophages (TAMs), and tumor-associated neutrophils (TANs) as well as neoplastic cells express and secrete matrix metalloproteinases (MMPs). Moreover, TME metabolic conditions such as hypoxia and acidification induce MMPs' synthesis in both cancer and stromal cells. MMPs' participation in TME consists in promoting events, for example, epithelial-mesenchymal transition (EMT), apoptosis resistance, angiogenesis, and lymphangiogenesis. MMPs also facilitate tumor cell migration through the basement membrane (BM) and extracellular matrix (ECM). The aim of the present chapter is to discuss MMPs' contribution to the evolution of cancer cells, their cellular origin, and their influence in the main processes that take place in the TME.

Encuesta de Percepción en Capacidad Instalada para la Formación de Médicos Residentes en Ortopedia (Traumatología) y Necesidades de la Atención en Patología Musculoesquelética Aguda y Crónica en México. Primera Parte / Installed Capacity Perception Survey for the Training of Resident's Program in Orthopedics and Care Needs in Acute and Chronic Musculoskeletal Pathology in Mexico

resumen está disponible en el texto completo

Abstract: Introduction: It is essential that orthopaedic resident physicians be highly proficient in all aspects, considering the balance between supply, demand, need and context. Fundamental to identify the capacity and quality installed for their training in Mexico. Material and methods: Observational Study, transverse, non-probabilistic sampling-conglomerates, in two phases. The instrument has 8 domains, 57 variables and 4,867 items. 60 graduate professors of 20 states, 50 hospital sites, 22 university programs. Results: 1,038 years of experience (collective intelligence), 17 years of experience/teacher (01 to 50 years). Identified: acute pathology 30 (2 to 90%), chronic pathology 30 (5 to 96%), patients ˂ 15 years, 10 (3 to 30%), patients between 15 and 65 years, 47 (2 to 78%), patients ˃ 65 years, 20 (2 to 60%), number of beds/seat 20 (2 to 510), number of clinics 3 (1 to 48), number of surgical procedures/headquarters per year at the national level, was 960 (50 to 24,650). The national average per resident doctor is 362 surgeries/year with 1,450 surgical times/year. Conclusions: The needs and resources for the training of physicians specializing in orthopedics/traumatology are highly heterogeneous, so it should be adapted to the epidemiological needs of the region of influence, in an area of epidemiological transition. 62.2% expressed not having or have bad academic and scientific infrastructure at its headquarters, more than 50% without rotation overseas and ˃ 90% without regular scientific production.

[Installed Capacity Perception Survey for the Training of Residents Program in Orthopedics and Care Needs in Acute and Chronic Musculoskeletal Pathology in Mexico]. / Encuesta de Percepción en Capacidad Instalada para la Formación de Médicos Residentes en Ortopedia (Traumatología) y Necesidades de la Atención en Patología Musculoesquelética Aguda y Crónica en México. Primera Parte.

INTRODUCTION: It is essential that orthopaedic resident physicians be highly proficient in all aspects, considering the balance between supply, demand, need and context. Fundamental to identify the capacity and quality installed for their training in Mexico. MATERIAL AND METHODS: Observational Study, transverse, non-probabilistic sampling-conglomerates, in two phases. The instrument has 8 domains, 57 variables and 4,867 items. 60 graduate professors of 20 states, 50 hospital sites, 22 university programs. RESULTS: 1,038 years of experience (collective intelligence), 17 years of experience/teacher (01 to 50 years). Identified: acute pathology 30 (2 to 90%), chronic pathology 30 (5 to 96%), patients 15 years, 10 (3 to 30%), patients between 15 and 65 years, 47 (2 to 78%), patients 65 years, 20 (2 to 60%), number of beds/seat 20 (2 to 510), number of clinics 3 (1 to 48), number of surgical procedures/headquarters per year at the national level, was 960 (50 to 24,650). The national average per resident doctor is 362 surgeries/year with 1,450 surgical times/year. CONCLUSIONS: The needs and resources for the training of physicians specializing in orthopedics/traumatology are highly heterogeneous, so it should be adapted to the epidemiological needs of the region of influence, in an area of epidemiological transition. 62.2% expressed not having or have bad academic and scientific infrastructure at its headquarters, more than 50% without rotation overseas and 90% without regular scientific production.

INTRODUCCIÓN: Es fundamental que los médicos residentes de ortopedia (traumatología) sean altamente competentes en todos los aspectos, considerando el equilibrio entre la oferta, demanda, necesidad y contexto. Es primordial identificar la capacidad y calidad instalada para su formación en México. MATERIAL Y MÉTODOS: Estudio observacional, transversal, muestreo no probabilístico-conglomerados, en dos fases. El instrumento tiene ocho dominios, 57 variables y 4,867 ítems. Sesenta profesores de postgrado de 20 estados, 50 sedes hospitalarias, 22 programas universitarios. RESULTADOS: 1,038 años de experiencia (inteligencia colectiva), 17 años de experiencia/profesor (01 a 50 años). Se identificó: patología aguda 30 (2 a 90%), patología crónica 30 (5 a 96%), pacientes 15 años, 10 (3 a 30%), pacientes entre 15 y 65 años, 47 (2 a 78%), pacientes 65 años, 20 (2 a 60%), número de camas/sede 20 (2 a 510), número de consultorios 3 (1 a 48), el número de procedimientos quirúrgicos/sede al año a nivel nacional fue de 960 (50 a 24,650). La media nacional por médico residente es de 362 cirugías/año con 1,450 momentos quirúrgicos/año. CONCLUSIONES: Las necesidades y recursos para la formación de médicos especialistas en ortopedia/traumatología son en alto grado heterogéneos, por lo cual se debería adaptar a las necesidades epidemiológicas de la región de influencia, en un ámbito de transición epidemiológica. Sesenta y dos punto dos por ciento expresó no tener o tener deficiente infraestructura académica y científica en su sede, más de 50% sin rotación al extranjero y 90% sin producción científica regular.

In vitro digestibility of normal and waxy corn starch is modified by the addition of Tween 80.

Aqueous dispersions of normal and waxy corn starch (3% w/w) were mixed with Tween 80 (0, 7.5, 15, 22.5 and 30 g/100 g of starch), and gelatinized (90 °C, 20 min). Optical microscopy of the gelatinized starch dispersions (GSDx; x = Tween 80 concentration) revealed that the microstructure was characterized by a continuous phase of leached amylose and amylopectin entangled chains, and a dispersed phase of insoluble remnants, called ghosts, on whose surface small granules were observed, imputed to Tween 80. The apparent viscosity of the GSDx decreased as the concentration of Tween 80 increased (up to about 70-90%). FTIR analysis of dried GSDx indicated that Tween 80 addition decreased short-range ordering. The content of rapidly digestible starch (RDS) and resistant starch (RS) fractions tended to increase significantly, at the expense of a significant decrease of slowly digestible starch (SDS) fraction, an effect that may be attributed to the increase of amorphous structures and starch chain-surfactant complexes. The RDS and RS increase was more pronounced for normal than for waxy corn starch, and the significance of the increase was dependent on Tween 80 concentration. Overall, the results showed that surfactant can affect largely the digestibility of starch chains.

[Incidence and effect of leg length discrepancy after total hip arthroplasty]. / Incidencia y efecto de la discrepancia en la longitud de la pierna después de la artroplastía total de cadera.

INTRODUCTION: In coxarthrosis pain relief and the restoration of function including leg length are achieved with total hip arthroplasty. Sometimes achieving stability makes it impossible to achieve equal leg length. OBJECTIVE: To determine the incidence of pelvic limb length discrepancy, its effect on function and its emotional effect in a group of patients who underwent total hip arthroplasty. MATERIAL AND METHODS: A total of 252 patients with a diagnosis of grade IV coxarthrosis were assessed. They underwent unilateral primary total hip arthroplasty with a direct lateral approach; 190 were uncemented and 162 hybrid. Limb length was measured from the anterosuperior iliac crest to the medial malleolus of both legs. Patients were divided into four groups depending on leg length discrepancy: A) equal length; B) less than 10 mm; C) more than 10 mm, and D) more than 20 mm. RESULTS: A total of 252 arthroplasties were performed in 252 patients; 194 females (76.98%) and 58 males (23.01%). In 115 patients (45.63%) had a discrepancy < 10 mm; 71 patients (28.17%) > 10 mm; 60 patients (23.80%) did not have length discrepancy, and six patients had > 20 mm of discrepancy with lengthening of the operated limb. CONCLUSIONS: Length discrepancy of the operated limb is reported in the literature. It is a common outcome of primary total hip arthroplasty, and is usually < 10 mm, as reported in world literature.

Sodium caseinate induces mouse granulopoiesis.

OBJECTIVE AND DESIGN: Sodium caseinate (CasNa) induces differentiation and M-CSF production in mouse band granulocytes in vitro; however, it is not yet known if this molecule can also induce the proliferation and activation of the granulocyte lineage in vivo. In this work we evaluated the induction in vivo of granulopoiesis and the activation of granulocytes in mice treated with CasNa. MATERIAL OR SUBJECTS: BALB/c male mice 8-12 weeks old were used. TREATMENT: The animals were inoculated intraperitoneally with 1 ml of CasNa (10% in PBS p/v) four times (every 48 h). METHODS: Granulocyte proliferation was evaluated by flow cytometry; activation was evaluated by phagocytic indices. The cytokine was measured using an ELISA assay. RESULTS: We show that CasNa increased bone marrow granulopoiesis percentage (38.35 ± 10.88 vs. 64.94 ± 34.14 BrdU+/Gr-1+ cells) and the granulocytes generated presented increased phagocytic indices (0.3 ± 0.1 vs. 0.6 ± 0.11, p < 0.05). We also show that G-CSF (974 ± 411 vs. 3189 ± 350 pg/ml, p < 0.05) and GM-CSF increased in serum, but only G-CSF in bone marrow plasma. CONCLUSIONS: CasNa induces granulopoiesis with functional granulocytes, suggesting that this molecule could be an innate immune system activator.

High glucose concentrations alter the biomineralization process in human osteoblastic cells.

Diabetes mellitus (DM) may alter bone remodeling, as osteopenia and osteoporosis are among the complications. Moreover, DM increases the risk and severity of chronic inflammatory periodontal disease, in which bone resorption occurs. Broad evidence suggests that chronic inflammation can contribute to the development of DM and its complications. Hyperglycemia is a hallmark of DM that may contribute to sustained inflammation by increasing proinflammatory cytokines, which are known to cause insulin resistance, via toll-like receptor (TLR)-4-mediated mechanisms. However, the mechanisms by which bone-related complications develop in DM are still unknown. Studies done on the effect of high glucose concentrations on osteoblast functions are contradictory because some suggest increases (although others suggest reductions) in the biomineralization process. Therefore, we evaluated the effect of high glucose levels on biomineralization and inflammation markers in a human osteoblastic cell line. Cells were treated with either physiological 5.5 mM or increasing concentrations of glucose up to 24 mM, and we determined the following: i) the quantity and quality of calcium-deposit crystals in culture and ii) the expression of the following: a) proteins associated with the process of biomineralization, b) the receptor activator of nuclear factor kappa-B ligand (RANKL) and osteoprotegerin (OPG), c) cytokines IL1, IL6, IL8, IL10, MCP-1 and TNF alpha, and d) TLR-2, -3, -4 and -9. Our results show that high glucose concentrations (12 mM and particularly 24 mM) alter the biomineralization process in osteoblastic cells and provoke the following: i) a rise in mineralization, ii) an increase in the mRNA expression of RANKL and a decrease of OPG, iii) an increase in the mRNA expression of osteocalcin, bone sialoprotein and the transcription factor Runx2, iv) a diminished quality of the mineral, and v) an increase in the expression of IL1beta, IL6, IL8, MCP-1 and IL10 mRNAs. In addition we found that both high glucose levels and hyperosmotic conditions provoked TLR-2, -3, -4 and -9 overexpression in osteoblastic cells, suggesting that they are susceptible to osmotic stress.

[Clinical competence of the family doctor in systemic arterial hypertension]. / Competencia clínica del médico familiar en hipertensión arterial sistémica.

OBJECTIVE: To establish clinical competence of family physicians to diagnose systemic arterial hypertension and to analyze it's associations with some variables related to working conditions and prior training. METHODS: The clinical competence was established in a non probabilistic sample of 165 family physicians working in 12 units of the Instituto Mexicano del Seguro Social (IMSS) in Mexico City. We used questionnaire of 160 items (true/false/don't know) to evaluate clinical competence. Association of the scores were explored for work shift (morning/afternoon), working conditions (very favorable/favorable/little favorable/unfavorable) and having been trained in a familiar medicine residency of the IMSS (yes/no). RESULTS: There were a general low competence to diagnose systemic arterial hypertension (median score of 36 of a possible 160). There were associations of competence with more favorable working conditions (p = 0.005 Kruskal-Wallis test) and with having been trained previously (p = 0.0123 U Mann-Whitney test). CONCLUSIONS: Our results support the need to continue in this area of research to improve measuring instruments and to identify the modifiers of clinical competence to overcome the deficiencies detected in the present study.

Ossification of the posterior longitudinal ligament in three geographically and genetically different populations of ankylosing spondylitis and other spondyloarthropathies.

STUDY DESIGN: Cross sectional. RESEARCH QUESTIONS: (a) Is any clinical variable of ankylosing spondylitis (AS) associated with the presence of ossification of the posterior longitudinal ligament (OPLL)? and (b) Is OPLL present in patients with AS from different geographical or genetic backgrounds? METHODS: Three groups were assembled: (1) a prospective group of 103 consecutive AS patients from two community based rheumatology clinics from Guadalajara, who were evaluated using: a questionnaire with disease characteristics variables; clinical assessment by a neurologist; lateral radiographic views of the cervical spine and somatosensory evoked potentials (SSEP). (2) Fifty one spondyloarthropathies (SpA) patients from Mexico city whose cervical spine films were retrospectively reviewed. (3) Thirty nine AS patients from Edmonton, Canada whose cervical spine films were retrospectively reviewed and compared with 72 controls. RESULTS: Group 1: 74% of the 103 patients were men and 86% were HLA-B27 positive. The mean age was 35 years, and mean (SD) disease duration 10 (8) years. OPLL was reported in 16 patients (15.5%; 95% CI 9, 22). OPLL was statistically associated with older age (p = 0.001), longer disease duration (p = 0.001), clinical myelopathy (p = 0.03), worst functional index (p = 0.042), restricted axial movement measurements (all p < 0.001), radiological sacroilitis (p < 0.001 for linear association), osteitis pubis (p = 0.009), hip involvement (p = 0.006 for linear association), and abnormal SSEP (p = 0.008). Group 2: 92% of 51 patients were men; the mean age was 30 years and the mean (SD) disease duration 11 (7) years. OPLL was reported in 15 (29%, 95% CI 17, 41) patients (nine AS, two psoriatic arthritis, three juvenile AS, and one Reiter's syndrome). Group 3: 95% of the 39 patients were men; the mean of age was 46 years and disease duration of 18 (10) years. OPLL was reported in nine (23%; 95% CI 10, 36) patients, including one with psoriatic arthritis, and two with Crohn's disease. OPLL was observed in two of the control group. CONCLUSIONS: The prevalence of OPLL in AS and SpA is higher than previously recognised and seems to be associated with variables identifying more severe axial disease.