Quantitative Monitoring of Syndesmophyte Growth in Ankylosing Spondylitis Using Computed Tomography

2014 ◽  
pp. 135-142
Author(s):  
Sovira Tan ◽  
Jianhua Yao ◽  
Lawrence Yao ◽  
Michael M. Ward
Keyword(s):  
Computed Tomography ◽  
Ankylosing Spondylitis ◽  
Quantitative Monitoring

Zygapophyseal Joint Fusion in Ankylosing Spondylitis Assessed by Computed Tomography: Associations with Syndesmophytes and Spinal Motion

2017 ◽  
Vol 44 (7) ◽  
pp. 1004-1010 ◽  
Author(s):  
Sovira Tan ◽  
Jianhua Yao ◽  
John A. Flynn ◽  
Lawrence Yao ◽  
Michael M. Ward
Keyword(s):  
Computed Tomography ◽  
Ankylosing Spondylitis ◽  
Spinal Mobility ◽  
Vertebral Level ◽  
Spinal Motion ◽  
Zygapophyseal Joints ◽  
Spinal Damage ◽  
Relationship Of ◽  
The Relationship ◽  
Level Fusion

Objective.Because zygapophyseal joints (ZJ) are difficult to visualize on radiographs, little is known about the relationship of ZJ fusion to other features of spinal damage in ankylosing spondylitis (AS). We used computed tomography (CT) to investigate the concordance of ZJ fusion and syndesmophytes, and examined the contribution of both features to spinal motion.Methods.We performed thoracolumbar CT scans (T10–T11 to L3–L4) on 55 patients. Two readers scored scans for ZJ fusion, which were compared to syndesmophyte height and extent of bridging, measured by computer algorithm at the same levels. We used multiple regression analysis to evaluate the relative contributions of ZJ fusion and syndesmophytes to spinal mobility.Results.Fifty-one percent of patients had ZJ fusion in at least 1 vertebral level. Fusion was present in 129 of 652 individual ZJ. Syndesmophytes and bridging were often present in vertebral levels without ZJ fusion, suggesting that syndesmophytes most often develop first. ZJ fusion was present in 34% of vertebral levels with syndesmophytes and 55.9% of levels with bridging, suggesting a closer association with bridging. Syndesmophytes and ZJ fusion had similar associations with the modified Schober test, but syndesmophytes were more strongly associated with limitations in lateral thoracolumbar flexion. ZJ rarely showed new fusion over 4 years.Conclusion.Thoracolumbar ZJ fusion in AS is rarely present at vertebral levels without syndesmophytes. Syndesmophytes, therefore, likely appear before ZJ fusion at a given vertebral level. Both syndesmophytes and ZJ fusion contribute to limited forward lumbar flexion, but syndesmophytes contribute more to limited lateral flexion.

scholarly journals Rapidly Progressive Pulmonary Apical Fibrosis and Parenchymal Destruction in a Patient with Ankylosing Spondylitis

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Hasan Ulusoy ◽  
Nazmiye Tibel Tuna ◽  
Aslı Tanrivermis Sayit
Keyword(s):  
Computed Tomography ◽  
Ankylosing Spondylitis ◽  
Rare Complication ◽  
Granulomatous Inflammation ◽  
Pulmonary Involvement ◽  
High Resolution Computed Tomography ◽  
Thoracic Computed Tomography ◽  
Breath Sounds ◽  
Chest X Ray ◽  
The Right

Pulmonary apical fibrosis is a rare complication of ankylosing spondylitis (AS). The essential characteristics of this lesion are its very slow progression and frequently asymptomatic nature. Herein, we are presenting a patient with AS who rapidly developed pulmonary apical fibrosis in a 3-year period despite decreased musculoskeletal pains. The 60-year-old male applied with complaints of progressively increasing cough in the recent two years, dyspnea, and fatigue. He had no chronic disease except AS. He had no continuous medication except nonsteroid anti-inflammatory drugs for 2-3 days monthly since his musculoskeletal pains decreased in the recent years. His physical examination revealed reduced breath sounds in the upper zones of the right lung. Chest X-ray revealed increased diffuse opacity in the upper zones of the right lung. Thoracic high-resolution computed tomography showed a consolidation accompanied with traction bronchiectases compatible with chronic fibrosis in the upper lobe of the right lung. However, thoracic computed tomography of the patient performed 3 years ago did not reveal pulmonary apical fibrosis and parenchymal destruction. Biopsy revealed no finding of malignancy, granulomatous inflammation, or vasculitis. The results of cultures were negative. So, the patient was diagnosed as pulmonary involvement of AS, which developed in a 3-year period. This case has shown that extra-articular complications may continue to develop in patients with AS even if their musculoskeletal complaints have subsided. So, patients with AS should be followed up regularly with systemic examinations.

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