The Thorax in Ankylosing Spondylitis

Pleural Involvement in Systemic Autoimmune Disorders

“…In ankylosing spondylitis (AS), pleural diseases are exceedingly rare [116,117,118,119,120], consisting of a handful of cases with pleural effusions [118, 121, 122]. In population studies, pleural disease has been identified in 2 of 53 patients (1 tuberculous and 1 nontuberculous effusion) [123, 124], 2 of 255 patients (idiopathic bilateral pleural calcification) [125] and 1 of 200 patients (unexplained pleural thickening) [126].…”

Acute bilateral pleural effusions in ankylosing spondylitis

“…Pulmonary manifestations are rare causing upper lobe fibro cavitary disease [1]. These have a significant variation in the literature [2]. Dudley-Hart et a1 [3] reported two patients with history of pleurisy and one of them had a pleural effusion in 1950.…”

Ankylosing Spondylitis

“…These measurements are remarkably constant and provide the best measure of the progress of spinal stiffness in any given case. In early cases, where pain rather than structural change prevents movement, a definite increase can be obtained in the spinal range as a result of treatment by any effective method, whether it be cortisone, ACTH, or deep x-ray therapy, the response being much more rapid with the first two but less lasting (Hart, 1952). In most cases, however, there is a considerable degree of fixation of the spine and, though the pain may be greatly relieved by different forms of treatment, the spinal range of movement increases little, if at all.…”

“…A characteristic feature of ankylosing spondylitis is the reduced rib excursion which occurs as a result of fusion of rib with transverse process and body of vertebra. This reduction in intercostal respiration leads to over-use of the diaphragm and a double exposure skiagram of the chest in inspiration and expiration will, in such cases, demonstrate little rib movement but a generous diaphragmatic excursion (Hart, Bogdanovitch, and Nichol, 1950;Hart, 1950). The picture, therefore, differs from that seen in emphysema where both rib and diaphragm move little.…”

“…Iritis and Iridocyclitis.-These ocular symptoms have long been recognized as more common in ankylosing spondylitis than in rheumatoid arthritis, but here again the length of the follow-up period will affect the results (Hart, 1951) and the incidence of 10 per cent. which is usually quoted, rises with an increase in the number of "observation years".…”