Colonoscopic Findings and Histological Changes in Patients Suffering from Ankylosing Spondylitis with Normal Bowel Habit

Ankylosing Spondylitis is a form of spondyloarthropathies characterized by chronic inflammation of the joints of axial skeleton, manifested clinically by pain and progressive stiffening of spine. It is evidenced that sero-negative spondyloarthropathies are closely related with gut inflammatory lesions. This inflammatory gut lesions may be clinically silent or with abnormal bowel symptoms. This observational study was done with an intension to see the inflammatory gut lesions in ankylosing spondylitis patients having normal bowel habit. In this study thirty eight ankylosing spondylitis patients were selected by New York revised criteria having normal bowel habit. All patients were subjected to full colonoscopy with biopsy. Only 7.89% patient showed macroscopic abnormalities (Grade-1 & 2) and 15.87 % had microscopic non-granulomatous inflammatory lesion of grade1 &2 on biopsy. This study concluded that gut inflammatory lesions in ankylosing spondylitis patients with normal bowel habit is not remarkable. So before making concrete opinion, further large sized comparable study with & without bowel symptoms can be warranted. DOI: 10.3329/taj.v22i1.5012 TAJ 2009; 22(1): 01-04

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Prevalence of Vertebral Fractures by Semiautomated Morphometry in Patients with Ankylosing Spondylitis

The Journal of Rheumatology ◽

10.3899/jrheum.100851 ◽

2011 ◽

Vol 38 (5) ◽

pp. 893-897 ◽

Cited By ~ 41

Author(s):

NURIA MONTALA ◽

XAVIER JUANOLA ◽

EDUARDO COLLANTES ◽

ELISA MUÑOZ-GOMARIZ ◽

CARLOS GONZALEZ ◽

...

Keyword(s):

New York ◽

Ankylosing Spondylitis ◽

Vertebral Fractures ◽

Axial Skeleton ◽

Chronic Inflammatory Disease ◽

National Registry ◽

Prevalent Vertebral Fracture ◽

High Prevalence ◽

Prevalent Fracture ◽

Semiquantitative Method

Objective.Ankylosing spondylitis (AS) is a chronic inflammatory disease mainly affecting the axial skeleton and characterized by ossification of the spinal disc, joints, and ligaments leading to progressive ankylosis. Vertebral osteoporosis is a recognized feature of AS. Studies have confirmed a moderate to high prevalence of vertebral fractures with extremely varying ranges in patients with AS. Our objective was to estimate the prevalence of vertebral fractures in a representative Spanish population of patients with AS using a validated semiquantitative method, MorphoXpress®.Methods.Patients were randomly selected from the 10 initial participating centers of the Spanish National Registry of Spondyloarthropathies (REGISPONSER) by consecutive sampling. All patients fulfilled the New York modified criteria for AS and had a baseline thoracolumbar radiograph. A prevalent vertebral fracture was defined according to the Genant classification criteria.Results.The estimated prevalence of vertebral fractures was 32.4% (95% CI 25.5%–39.3%). The majority of fractures were localized in the thoracic segment (n = 100; 82.%) and were mild (n = 79; 64.8%). In logistic regression analysis, age (odds ratio per year 1.05, 95% CI 1.03–1.08, p < 0.001), disease duration (OR per year 1.03, 95% CI 1.01–1.06, p = 0.011), Bath Ankylosing Spondylitis Functional Index score (OR per score 1.16, 95% CI 1.03–1.30, p = 0.015), Bath Ankylosing Spondylitis Radiographic Index-TS (OR per score 1.25, 95% CI 1.12–1.39, p < 0.001), and wall-occiput distance (OR per cm 1.15, 95% CI 1.08–1.23, p < 0.001) were all associated with prevalent fracture.Conclusion.Semiquantitative methods are needed to improve the diagnosis of vertebral fractures in AS in order to start early treatment and to avoid complications arising from osteoporosis.

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OP0255 THE ROLE OF PELVIC MORPHOLOGY IN AXIAL SPONDYLOARTHRITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.188 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 156.1-156

Author(s):

E. Zaccagnino ◽

R. Patel ◽

L. S. Gensler

Keyword(s):

New York ◽

Ankylosing Spondylitis ◽

Axial Spondyloarthritis ◽

Axial Skeleton ◽

Chronic Inflammatory Disease ◽

Cross Sectional ◽

Radiographic Damage ◽

Pelvic Morphology ◽

The Relationship

Background:Axial Spondyloarthritis (axSpA) is a chronic inflammatory disease affecting the axial skeleton. It includes non-radiographic axSpA and radiographic axSpA [Ankylosing Spondylitis (AS)]. Male axSpA patients often have greater damage, while women report a higher disease burden. The role of pelvic morphology in the axSpA phenotype has not been explored. There is anatomic sexual dimorphism between the male and female pelvis. Given the phenotypic gender differences in axSpA, the role of pelvic morphometry is of interest.Objectives:The purpose of this study is to determine whether an association exists between pelvic dimensions and radiographic damage in patients with axSpA, as well as to compare these measurements in axSpA patients and healthy controls.Methods:This was a cross-sectional analysis comparing axSpA cases from a prospective cohort and non-axSpA controls from the UCSF radiology databank. Informed consent was obtained from axSpA cohort patients and this study was approved by the institutional IRB. To be included in the analysis, we limited inclusion to age ≤ 50 with an Anterior Posterior (AP) pelvis radiograph in the system. We excluded non-nulliparity, pelvic fracture history, BMI ≥ 30kg/m2, any prosthetic history and avascular necrosis. We measured the pelvic inlet, pelvic outlet, and subpubic angle (based on validated scoring methods) (Figure 1) and assessed its relation to sacroiliac joint (SIJ) damage (average SIJ score, New York criteria) and modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) in cases. AxSpA patients were also compared to age/gender matched controls. Pelvic measurements were performed by 2 blinded independent-trained readers in randomized, blinded image order. Inter-rater reliability was assessed. When examining the relationship between pelvic measurements and damage, linear regression was used to stratify by gender and adjust for potential confounders.Results:The axSpA cohort included 481 patients, of which 210 men and 89 women were included in this analysis and gender/age matched controls. Rater inter-class correlation was above 0.70 for pelvic outlet and above 0.80 for other measures. Cases and controls were similar (Table 1). The regression analysis showed a significant relationship between the sub-pubic angle and damage in the spine (coeff=-0.342, p=0.003) in men with axSpA. A sensitivity analysis, excluding mSASSS outliers (mSASSS ≥ 16) upheld the relationship (coeff=-1.40, p=0.002).Conclusion:In men with axSpA, there appears to be a relationship between sub-pubic angle and spinal radiographic damage. This is consistent with our finding that women have larger sub-pubic angles and lower spinal radiographic damage than men. A greater sub-pubic angle may protect against spinal involvement or associate with other protective factors. Further work should be performed to understand the contribution of pelvic anatomy to damage in axSpA.Disclosure of Interests:Ethan Zaccagnino: None declared, Rina Patel: None declared, Lianne S. Gensler Consultant of: AbbVie, Eli Lilly, Gilead, Novartis, Pfizer and UCB., Grant/research support from: Pfizer and UCB.

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Seronegative Spondyloarthritis

10.2310/im.1022 ◽

2017 ◽

Author(s):

Walter P Maksymowych

Keyword(s):

New York ◽

Ankylosing Spondylitis ◽

Intestinal Inflammation ◽

Inflammatory Diseases ◽

Axial Skeleton ◽

Comprehensive Overview ◽

Radiographic Images ◽

Record Keeping ◽

Eular Recommendations ◽

Effector Cytokines

The term spondyloarthritis encompasses a family of clinically, epidemiologically, and genetically related inflammatory diseases that primarily affect spinal and peripheral joints. The prototypic disease known as ankylosing spondylitis is characterized by progressive ankylosis in the joints of the axial skeleton that is readily evident on radiography and culminates in a permanently stooped spinal posture. Disease may not progress to ankylosis and may initially affect the peripheral joints and entheses, so the term spondyloarthritis is now considered the more appropriate term for this group of arthritides. This review provides a comprehensive overview of the classification, epidemiology, pathogenesis (including genetic factors, effector cytokines, bacteria and intestinal inflammation, and the link between inflammation and spinal ankylosis), pathology, diagnosis, management (including patient education, physical modalities, symptom-modifying antirheumatic drugs, second-line agents, biologic therapies, antibiotics, and surgery), and prognosis of spondyloarthritis. Graphs, algorithms, illustrations, and radiographic images are provided. Tables outline the modified New York criteria for ankylosing spondylitis, disease associations with genes outside the HLA locus in ankylosing spondylitis and overlap with Crohn disease and psoriasis, Assessments in SpondyloArthritis international Society (ASAS)/European League against Rheumatism (EULAR) recommendations for the management of ankylosing spondylitis, 2010 recommendations for the use of anti–tumor necrosis factor agents in patients with axial spondyloarthritis, and the ASAS core set for clinical record keeping. This review contains 15 highly rendered figures, 5 tables, and 176 references.

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Ankylosing Spondylitis: Discussions in Patient Management. By Andrei Calin, M.A., M.R.C.P., M.D. and James F. Fries, M.D.; 1978. New York: Medical Examination Publishing Co. Inc.: Sydney: Ramsay Surgical Ltd. 21¼ cm × 13½ cm, pp. 118, with illustrations. Price: $13.30

The Medical Journal of Australia ◽

10.5694/j.1326-5377.1980.tb134810.x ◽

1980 ◽

Vol 1 (S2) ◽

pp. 243-243

Author(s):

Malcolm Begg

Keyword(s):

New York ◽

Ankylosing Spondylitis ◽

Patient Management ◽

Medical Examination ◽

York Medical

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Psychological Correlates of Self-reported Disease Activity in Ankylosing Spondylitis

The Journal of Rheumatology ◽

10.3899/jrheum.090476 ◽

2010 ◽

Vol 37 (4) ◽

pp. 829-834 ◽

Cited By ~ 29

Author(s):

TAMAR F. BRIONEZ ◽

SHERVIN ASSASSI ◽

JOHN D. REVEILLE ◽

CHARLES GREEN ◽

THOMAS LEARCH ◽

...

Keyword(s):

New York ◽

Ankylosing Spondylitis ◽

Disease Activity ◽

Activity Index ◽

Disease Activity Index ◽

Multivariate Regression Analysis ◽

Passive Coping ◽

Psychological Variables ◽

Psychological Measures

Objective.To investigate the role of psychological variables in self-reported disease activity in patients with ankylosing spondylitis (AS), while controlling for demographic and medical variables.Methods.Patients with AS (n = 294) meeting modified New York criteria completed psychological measures evaluating depression, resilience, active and passive coping, internality, and helplessness. Demographic, clinical, and radiologic data were also collected. Univariate and multivariate analyses were completed to determine the strength of the correlation of psychological variables with disease activity, as measured by the Bath AS Disease Activity Index (BASDAI).Results.In the multivariate regression analysis, the psychological variables contributed significantly to the variance in BASDAI scores, adding an additional 33% to the overall R-square beyond that accounted for by demographic and medical variables (combined R-square 18%). Specifically, arthritis helplessness and depression accounted for the most significant portion of the variance in BASDAI scores in the final model.Conclusion.Arthritis helplessness and depression accounted for significant variability in self-reported disease activity beyond clinical and demographic variables in patients with AS. These findings have important clinical implications in the treatment and monitoring of disease activity in AS, and suggest potential avenues of intervention.

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