The Epidemiology of Spondylodiscttis in Ankylosing Spondylitis—a Controlled Study

Kabasakal, Yasemin; Garrett, Sylvester; Calin, Andrei

doi:10.1093/rheumatology/35.7.660

Cited by 73 publications

(35 citation statements)

References 7 publications

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“…Nevertheless, AL often involves only a single level, indicating that additional factors could be involved [14]. An infectious origin has also been suggested because of the radiographic resemblance to spondylodiscitis [15,16], but this has never gained much popularity in literature. Regardless of the exact etiology, a final common pathway exists, in which mechanical stresses prevent the lesion from fusion and the development of pseudarthrosis ensues [1].…”

Section: Discussionmentioning

confidence: 99%

Andersson lesion: are we misdiagnosing it? A retrospective study of clinico-radiological features and outcome of short segment fixation

2011

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This study reviews the presentation, etiology, imaging characteristics and reasons for missed diagnosis of Andersson lesion (AL) and analyzes the surgical results of short segment fixation in the thoracolumbar region. This is a retrospective single center study. Fourteen patients (15 lesions) who were operated for AL were analyzed. The study was designed in two parts. The first part consisted of analysis of clinical and radiological features (MRI and radiographs) to highlight, whether definitive characteristics exist. The second part consisted of analysis of outcome of short segment fixation as measured by VAS, Frankel score, AsQoL index, and union, with assessment of complications. The follow-up was 42.33 ± 19.29 months (13 males and 1 female) with a mean age of 61.13 ± 19.74 years. There was predisposing trauma in five patients. There was a delay in presentation of the patients by 5.86 ± 2.50 months. There was misdiagnosis in all the cases, at primary orthopedic level (ten cases were put on anti-tuberculous treatment due to its MRI resemblance to infection) and all but one case at radiologist level. Radiographs and MRI had characteristic features in all cases, and MRI could detect posterior element affection in 14 lesions as against only 8 posterior lesions detected in radiographs. In all patients, there was a patient's delay and/or physician's delay to arrive at a diagnosis. Spinal fusion was seen in all the cases. Outcome measures of VAS, Frankel score, and AsQoL index showed significant improvement (P \ 0.002). No major complications occurred. There is a lack of awareness of AL leading to misdiagnosis. Definite clinico-radiological features do exist in AL and short segment fixation is effective.

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Section: Discussionmentioning

confidence: 99%

Andersson lesion: are we misdiagnosing it? A retrospective study of clinico-radiological features and outcome of short segment fixation

2011

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“…Even though in AS some Authors reported a frequency of discovertebral erosions in a range of 1.5-28% (22,23), in EA our research group has recently found a high prevalence of this lesion (30.55%), confirming that they are an important characteristic aspect of all SpA. In particular, we found a high prevalence in patients with axial and peripheral subset (31.82%), suggesting that spondylodiscitis could be a characterizing feature of the overlap subset, type 3 axial and peripheral forms (16).…”

Section: Articular Manifestationsmentioning

confidence: 98%

Articular and other Immune-Mediated Extra-Intestinal Manifestations in Inflammatory Bowel Diseases

et al. 2014

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The articular involvement in patients with inflammatory bowel diseases is included in the group of immune-mediated extra-intestinal manifestations, occurring approximately in a range from 6.2–36% of the patients. This group is also made up of the skin and eyes manifestations, that usually but not invariably are correlated with intestinal inflammatory disease activity. Rheumatic manifestations are the most frequent extra-intestinal findings of this group with a prevalence from 20–50%. They are divided into two different clinical subsets: peripheral and axial joint involvement (including sacroiliitis with or without spondylitis). Peripheral arthritis is the most frequent finding in both Crohn's disease and ulcerative colitis, occurring with a frequency ranging from 17–20%, and it is more common in Crohn's disease. Axial involvement is more common in Crohn's disease (5–22%) than in ulcerative colitis (2–6%) and generally the prevalence of sacroiliitis (asymptomatic and symptomatic) is between 12–20% and of spondylitis is between 2–16%. The IBD is also associated with other rheumatic diseases such as rheumatoid arthritis, Sjogren syndrome, Takayasu arteritis and fibromyalgia. The management of patients with EA requires an active cooperation between gastroenterologists and rheumatologists.

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“…5). Solche Veränderungen kommen in weniger als 10% der Patienten mit AS vor [24]. In der MRT-STIR-Sequenz zeigen sie sich als hyperintenses Signal in der Bandscheibe und in entweder einem oder beiden angrenzenden Wirbelkörpern.…”

Section: Spondylodiszitisunclassified

MRT-Untersuchungen bei axialer und peripherer Spondyloarthritis

Baraliakos

Braun

2012

Z. Rheumatol.

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The diagnosis of ankylosing spondylitis (AS) is based on the modified New York criteria and therefore on defined structural changes in the sacroiliac joint as detected by conventional radiographs. However, x-rays are not able to detect early stages of the disease in which inflammation predominates and irreversible structural changes have not yet taken place. This probably contributes to a substantial time delay until a diagnosis is made. Magnetic resonance imaging (MRI) is able to visualize active and chronic changes in axial and peripheral spondyloarthritis (SpA) even before the occurrence of structural changes. The ability to demonstrate both active and, in a limited way, also structural changes makes MRI a diagnostic tool of increasing importance in the management of SpA. However, conventional radiographs are still the gold standard for the assessment of structural changes in SpA. A combination of both imaging techniques is recommended in clinical practice.

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The Epidemiology of Spondylodiscttis in Ankylosing Spondylitis—a Controlled Study

Abstract: (1) spondylodiscitis occurs in approximately 8% of patients with AS; (2) these patients have early onset of disease; (3) multiple-level lesions in the spine are not uncommon among those with spondylodiscitis; (4) lesions are usually asymptomatic.

Cited by 73 publications

References 7 publications

Andersson lesion: are we misdiagnosing it? A retrospective study of clinico-radiological features and outcome of short segment fixation

Andersson lesion: are we misdiagnosing it? A retrospective study of clinico-radiological features and outcome of short segment fixation

Articular and other Immune-Mediated Extra-Intestinal Manifestations in Inflammatory Bowel Diseases

MRT-Untersuchungen bei axialer und peripherer Spondyloarthritis

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