36 hours ago Download Citation | Case report of multiple implant failure in a patient with ankylosing spondylitis | This report details a case of multiple implant failure (so … >> Go To The Portal
This report details a case of multiple implant failure (so-called 'cluster phenomenon') in a patient with ankylosing spondylitis and considers some factors for implant failure including reduced bone density.
Frequency of temporomandibular joint (TMJ) involvement in patients with ankylosing spondylitis (AS) has varied from 4% to 35%. It is more common in men and produces generalised stiffness in involved joints.
Conclusions: Ankylosing spondylitis is a multisystem inflammatory disorder, whose natural course includes periods of flares and remission. The peculiarity of this case consists in the early development of anti-Infliximab antibodies (secondary non-responder).
Ankylosing spondylitis (also named radiogra- tional radiography. A nkylosing spondylitis (AS) is an ning of a joint, and „spondylos”, which means vertebra. which improves with exercise 2. It is often associated of onset being between 20 and 30 years 1.
Background Axial spondyloarthritis (axSpA) is a common chronic inflammatory disease with predominantly axial symptoms. Besides axial symptoms, the disease is characterized by peripheral (arthritis, enthesitis, dactylitis), and extra-articular (uveitis, psoriasis, inflammatory bowel disease (IBD)) disease manifestations. A much debated question is whether the radiographic form (defined as ankylosing spondylitis or AS) and the non-radiographic form (nr-axSpA) of axSpA represent subsets of the same disorder or if they are distinct disease entities (1–4). Hypothesizing that AS and nr-axSpA reflect subsets of a single disease entity and have similar disease burden, we performed a meta-analysis of published studies of axial SpA in order to assess if the prevalence of peripheral and extra-articular disease manifestations is similar in AS and nr-axSpA. Objectives The objective of this meta-analysis was to assess the prevalence of peripheral and extra-articular disease manifestations in AS and nr-axSpA. Methods We performed a systematic literature search to identify publications describing the prevalence of peripheral and extra-articular disease manifestations in patients with AS and nr-axSpA. We assessed the risk of bias, between-study heterogeneity and extracted data. Pooled prevalence and prevalence differences were calculated. Results Eight studies including 2236 AS patients and 1242 nr-axSpA patients were included. Seven out of 8 studies were longitudinal cohort studies. There was a male dominance in AS (70.4%; 95% CI 64.4–76.0%) but not in nr-axSpA (46.8%; 95% CI 41.7–51.9), which was independent from HLA-B27 prevalence. HLA-B27 prevalence was similar in AS (78.0%; 95% CI 73.9–81.9%) and nr-axSpA (77.4%; 95% CI 68.9–84.9%). The pooled prevalence of arthritis (29.7% (95% CI 22.4–37.4%) versus 27.9% (95% CI 16.0–41.6%)), enthesitis (30.4% (95% CI 3.7–65.8%) versus 34.1% (95% CI 4.7–71.0%)), dactylitis (6.0% (95% CI 4.7–7.5%) versus 6.0% (95% CI 1.9–12.0%)), psoriasis (10.2% (95% CI 7.5–13.2%) versus 10.9% (95% CI 9.1–13.0%)) and IBD (4.1% (95% CI 2.3–6.5%) versus 6.4% (95% CI 3.6–9.7%)) were similar in AS and nr-axSpA. The pooled uveitis prevalence was higher in AS (23.0% (95% CI 19.2–27.1%)) than in nr-axSpA (15.9% (95% CI 11.8–20.4%)). Conclusions Peripheral and extra-articular manifestations are equally prevalent in AS and nr-axSpA, except for uveitis, which is slightly more prevalent in AS. These data support the concept that AS and nr-axSpA belong to one pathogenic entity with similar disease manifestations. • Wallis D, et al. Ankylosing spondylitis and nonradiographic axial spondyloarthritis: part of a common spectrum or distinct diseases? J Rheumatol 2013;40:2038–41. • Rudwaleit M, Khan MA, Sieper J. Commentary: The challenge of diagnosis and classification in early ankylosing spondylitis: Do we need new criteria? Arthritis Rheum 2005;52:1000–1008. • Robinson PC, et al. Axial spondyloarthritis: a new disease entity, not necessarily early ankylosing spondylitis. Ann Rheum Dis 2013;72:162–4. • Kiltz U, et al. Do patients with non-radiographic axial spondylarthritis differ from patients with ankylosing spondylitis? Arthritis Care Res 2012;64:1415–22. Disclosure of Interest None declared
Spondyloarthropathies (SpA) are a group of inflammatory arthritis which consist of ankylosing spondylitis (AS), reactive arthritis, arthritis/spondylitis associated with psoriasis (PsA), and arthritis/spondylitis associated with inflammatory bowel diseases. It is now more important than ever to diagnose and treat SpA early. New therapeutic agents including blockers of tumor necrosis factor have yielded tremendous responses not only in advanced disease but also in the early stages of the disease. Sacroiliitis on conventional radiography is the result of structural changes which may appear late in the disease process. However, magnetic resonance imaging (MRI) can visualize active inflammation at sacroiliac joints and spine in recent onset disease. The modified New York criteria, the European Spondyloarthropathy Study Group criteria and the Amor criteria do not include advanced imaging techniques like MRI which is very sensitive to the early Inflammatory changes. Assessment of SpondyloArthritis international Society has defined MRI methods for the assessment of sacroiliac joints and spine, criteria for inflammatory back pain and developed new criteria for classification of axial and peripheral spondyloarthritis. These new criteria are intended to be used for patients with SpA at the very early stage of their disease. Also, classification of psoriatic arthritis study group developed criteria for the classification of PsA. The widespread use of these criteria in clinical trials will provide evidence for a better definition of early disease and recognize many patients who may further develop classical AS or PsA. These efforts will guide therapeutic trials of potent drugs like biological agents in the early stage of these diseases.
Immune cells and innate cytokines have been suggested to be crucial in the pathogenesis of AS, especially human leukocyte antigen (HLA)‑B27 and the interleukin‑23/17 axis. However, the pathogenesis of AS remains unclear. The current study reviewed the etiology and pathogenesis of AS, including genome-wide association studies and cytokine pathways. This study also summarized the current pharmaceutical and surgical treatment with a discussion of future potential therapies.
Ankylosing spondylitis is an inflammatory condition involving the axial spine, often associated with the human leukocyte antigen (HLA)-B27 genotype and supporting radiographic imaging findings. Patients develop symptomatic low back and/or hip pain beginning in late adolescence or early adulthood. Diagnosis of ankylosing spondylitis is based primarily on clinical presentation and imaging studies. In this article, we are presenting a case of a 40-year-old male patient who presented to the office with chief concerns of chronic mid-thoracic back pain and restricted range of motion of his neck. The imaging study obtained was suggestive of fusion of the sacroiliac joints. This article also highlights the presence of elevated inflammatory markers in the setting of the patients chronic symptomatic complaints which could have guided in early diagnosis.