1/12. VATER association: is it recognised by rheumatologists?The authors describe an adult patient with history of chronic low back pain and recurrent prostatitis, marked limitation of lumbar spine motion and a radiograph demonstrating fused lumbar vertebrae, which suggest a diagnosis of spondylarthropathy. However, the absence of radiographic evidence of sacroilitis, the nature of the vertebral defects and a history of imperforate anus pointed towards the diagnosis of VATER association, rather than a spondylarthropathy. Although most patients with VATER association are diagnosed during infancy, the musculoskeletal anomalies can be overlooked while the potentially life-threatening problems are under treatment. These anomalies may become evident later in life. Therefore, in a rheumatologic practice, when evaluating patients with back pain and vertebral anomalies, one should become familiar with the varied manifestations of VATER association.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/12. Ankylosing spondylitis manifested by spontaneous anterior atlantoaxial subluxation.The onset of ankylosing spondylitis is usually characterized by lower back pain and stiffness in young adults; early diagnosis is not easy, but the disease is generally identified within a few years of onset. Anterior atlantoaxial subluxation may occur in the late stage of ankylosing spondylitis, but early spontaneous subluxation is rarely seen. We present a case of ankylosing spondylitis with an initial symptom of neck pain, rather than lower back pain, due to spontaneous anterior atlantoaxial subluxation. After medical and surgical intervention, except for limited range of motion, the patient experienced neither neck pain nor weakness of his left limbs during the next 8 mo of follow-up.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
3/12. Cervical involvement in juvenile-onset ankylosing spondylitis with bone scintigraphy.Juvenile-onset ankylosing spondylitis is an unusual disorder which can present with either peripheral arthritis or more classic hip girdle and back symptoms. A 12-year-old child with this disease was admitted with walking disorder, cervical pain, restricted cervical motion, and right ankle swelling. Diffusely increased accumulation of radioactivity in the cervical spine, focally increased accumulation in bilateral sacroiliac joints, and diminished irregular uptake in thoracal spine were detected on technetium 99m methylene diphosphonate bone scintigraphy. As a result, this imaging technique may give important information for diagnosis and differential diagnosis in juvenile chronic arthritis.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
4/12. A patient with ankylosing spondylitis who presented with chronic necrotising aspergillosis: report on one case and review of the literature.Upper lobe fibrobullous disease is a well-known finding in advanced stages of ankylosing spondylitis (AS). In this report, we present a 57-year-old male patient who was diagnosed with a right apical cavitary lesion after coming to us with the complaint of haemoptysis. The patient underwent upper lobe segmentectomy and an aspergilloma was detected. Histologic findings were in favour of necrotising aspergillus pneumonia. It was interesting that the patient had not been diagnosed with AS before and presented initially with chronic necrotising aspergillus pneumonia. In the literature, there are recently published series of pulmonary high-resolution computed tomography (HRCT) in AS which claim that parenchymal abnormalities are quite frequent. Although the clinical significance of these abnormalities is not known with certainty, it has been reported that they might be seen even in early-stage patients. It is suggested that the pulmonary involvement in AS might be affected by mechanical factors related to limitation of motion of the thoracic cage and also by parenchymal inflammation. Here, we review the series of pulmonary HRCT in AS patients.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
5/12. Clinical and radiographic "reankylosis" following hip surgery in ankylosing spondylitis.Eleven patients with ankylosing spondylitis underwent reconstructive hip surgery (21 hips). In 10 of these hips multiple surgical procedures had been performed. The final procedure included total hip arthroplasties (16 hips), femoral cup arthroplasties (four hips) and an Austin-Moore prosthetic replacement (one hip). A clinical and radiographic evaluation in the postoperative period revealed a high incidence of decreased joint motion and heterotopic ossification. Clinically moderate to severe restriction of motion was noted in 12 hips, and in six of these "reankylosis" was present. Radiographically moderate to severe new bone formation was seen in 11 hips, and in nine of these "reankylosis" was suggested. An association of excessive ossification and multiple surgical procedures was evident. It would appear that when the prime indication for hip surgery in patients with ankylosing spondylitis is restricted motion, the operation may not be beneficial.- - - - - - - - - - ranking = 3keywords = motion (Clic here for more details about this article) |
6/12. Ankylosing spondylitis associated with temporomandibular joint ankylosis: report of a case.Ankylosing spondylitis is a disease process that causes inflammatory changes of the involved joints. Often the first clinical indication of the condition is lumbosacral pain and discomfort with limited range of motion. Progressive synovial changes eventually involve all of the axial joints including the temporomandibular joint. Although temporomandibular joint dysfunction is usually found in patients with ankylosing spondylitis, there are only nine documented cases of true bony ankylosis. A case report and review of the literature of ankylosis spondylitis associated with true temporomandibular joint bony ankylosis is presented. Surgical treatment included a gap arthroplasty and placement of an interpositional Silastic implant.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
7/12. Pseudopseudarthrosis in a patient with ankylosing spondylitis.There is a growing consensus that the mechanism leading to extensive discovertebral destruction (type III) in most patients with ankylosing spondylitis relates to fracture and subsequent pseudarthrosis. We introduced the term "pseudopseudarthrosis" to describe (in our case) the occurrence of abnormal motion between 2 fused spinal segments, resulting in extensive discovertebral destruction without fracture or pseudarthrosis.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
8/12. Erosive temporomandibular joint disease as a feature of the spondyloarthropathy of ulcerative colitis.A patient with ankylosing spondylitis associated with ulcerative colitis developed bilateral temporomandibular joint pain and severe restriction of jaw motion. Conventional radiographs did not show structural abnormality of the temporomandibular joints, but corrected axis tomography revealed erosions in both mandibular condyles with extensive reactive sclerosis in the subchondral bone. These findings suggest that the temporomandibular joint disease in this case was a feature of the patient's spondylitis rather than a manifestation of the peripheral joint arthritis which commonly occurs in patients with ulcerative colitis.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
9/12. Cricoarytenoid arthritis and ankylosing spondylitis.A variety of systemic diseases may manifest with laryngeal symptoms. Cricoarytenoid arthritis with or without limitation of vocal fold motion is an example. It has been described in up to 25% of rheumatoid patients. Ankylosing spondylitis is classified among the seronegative spondylarthritides. Besides its systemic features, rare reports of cricoarytenoid involvement have been published. Six previous cases reported have been characterized by a long history of ankylosing spondylitis before the cricoarytenoid joint involvement occurred. We describe only the seventh case of cricoarytenoid arthritis secondary to ankylosing spondylitis and the first patient (to our knowledge) to present with bilateral vocal fold fixation as the initial presenting symptom.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
10/12. Ankylosing spondylitis successfully treated with methotrexate.A 37-year-old man with ankylosing spondylitis (AS) and psoriasis who was successfully treated with methotrexate (MTX) is reported. In 1980, he had low back pain, limited motion in the lumbar spine, radiological findings of bilateral sacroiliitis, and HLA-B27 positivity. In January 1991, he developed psoriasis and he had difficulty in performing desk work in spite of treatment with antirheumatic drugs. In May 1991, MTX 7.5 mg/week per os was started. Joint symptoms, psoriasis, and acute phase reactants improved within 1 month after the treatment and this improvement continued for more than 6 months after the treatment. After discharge he was able to return to his job.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
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