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[Spondylodiscitis in Bechterew's disease; inflammation or trauma? Description of 6 patients]
P J Lanting1, J J Rasker, M W Kruijsen
1Medisch Spectrum Twente, afd. Reumatologie, Enschede.
Objective:
To study the prevalence and nature of sterile spondylodiscitis in patients suffering from ankylosing spondylitis.
Design:
Descriptive.
Setting:
Department of Rheumatology, Medisch Spectrum Twente, Enschede, the Netherlands.
Method:
Of all ankylosing spondylitis patients suffering from sterile spondylodiscitis, the medical histories and the radiological and histological findings were analysed.
Results:
Among about 400 patients, 6 cases of sterile spondylodiscitis were found; 4 men and 2 women. The mean time lapse between diagnosis of ankylosing spondylitis and onset of spondylodiscitis symptoms was 7 years; in I patient discitis was the first symptom. Discitis changed the nature of the backache: it worsened during exercise and improved on resting. There was no history of trauma. Symptomatic and asyptomatic radiological abnormalities were seen at the same time in 2 patients. Symptoms disappeared 3-36 months after start of conservative treatment. Histological examination was performed in 2 cases and showed inflammatory changes.
Conclusion:
Spondylodiscitis in ankylosing spondylitis has a highly variable presentation and in general a good prognosis. Our findings support an inflammatory rather than a traumatic pathogenesis.