[Problems of mis- and late diagnosis in ankylosing spondylitis]

In 165 patients suffering from spondylitis ankylosans average retardations of the diagnosis of 4.6 years since the first anamnestic references typical for the disease could be established. More than half of 125 patients had already irreversible ankyloses at the time when the diagnosis was made, 9 of them had already an ankylosation in all segments of the spiral column. Apart from objective early diagnostic difficulties which are typical for the disease and retarded consultation of a physician in one third of all retardations of the diagnosis of more than 2 years iatrogenic causes were essential. The differential-diagnostic difficulties existed particularly concerning the delimitation to functional and degenerative vertebragenic syndromes, in the classification of easier and atypical forms of the course and the existence of extravertebral initial symptoms. The majority of false and late diagnoses could have been avoided by an exact anamnesis and with the help of simple clinical examinations.