HISTOPATHOLOGY OF DIARTHRODIAL JOINTS IN ANKYLOSING SPONDYLITIS
HISTOPATHOLOGY OF DIARTHRODIAL JOINTS IN ANKYLOSING SPONDYLITIS
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DOI：
10.1136/ard.10.4.393
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发表时间：
1951-01-01
影响因子：
27.4
通讯作者：
CRUICKSHANK, B
中科院分区：
文献类型：
--
作者：
CRUICKSHANK, B
关于强直性脊柱炎病理学的文献中，仅有3篇文章描述了双关节的组织病理学（Guntz，1933; Freund，1942;柯林斯，1949）。此外，这些论文主要关注的是疾病的病理晚期和临床非活动期，很少有插图。尽管缺乏足够的病理学研究，但人们普遍认为强直性脊柱炎是类风湿性关节炎的一种变异，而不是一种独立的疾病。因此，本文的目的是：（a）详细描述和说明强直性脊柱炎，特别是临床活动性病例的二关节的组织病理学。（B）讨论强直性脊柱炎和类风湿性关节炎之间的关系，因为它们影响这种类型的关节。三个例子来自尸检研究，其他九个是在手术中获得的。第一个尸检病例在死亡时临床活动和涉及的关节数量方面都是例外。几乎身体的每一个关节都受到影响，其中大多数显示出一定程度的关节强直。对该病例进行了广泛的研究，组织学检查包括右膝的几个组织块，右第一脚趾和右内侧楔骨-第一跖骨关节的所有关节的一个组织块，每个骶髂关节的几个组织块，每个胸锁关节的一个组织块，几个肋胸骨关节的每个组织块，以及柄胸骨关节的几个组织块。在尸检时，从第九胸椎到第三骶椎的脊柱被移除，并从许多椎间关节、椎间盘和左侧第十肋椎关节中取出块。许多插图都取自该案例（图8、10-14、16、18）。在第二个尸检病例中仅涉及轴关节;详细检查了T3至L4的脊柱、胸骨关节和耻骨联合。第三个尸检病例是Freund（1942）已经报道过的，有许多腰椎切片。
The literature on the pathology of ankylosing spondylitis contains only three articles in which the histopathology of diarthrodial joints is described (Guntz, 1933; Freund, 1942; Collins, 1949). Furthermore, these papers are concerned mainly with pathologically late and clinically inactive stages of the disease and have few illustrations. Despite the lack of adequate pathological study, it is widelyheld that ankylosing spondylitis isa variant of rheumatoid arthritis, rather than a separate disease. The objects of this paper are therefore:(a) to describe and illustrate in detail the histopathology of the diarthrodial joints in ankylosing spondylitis, particularly in clinically active cases,(b) to discuss the relationship between ankylosing spondylitis andrheuma-toid arthritis as they affect this type of joint.Material Tissue was obtained from twelve cases of ankylosing spondylitis. Three examples were from post-mortem studies, and the other nine were obtained at operation. The first post-mortem case was exceptional in being clinically active at the time of death and in the number of joints involved. Practically every joint in the body was affected, most of them showing some degree of ankylosis. This case was extensively studied and histological examination included several blocks from the right knee, one from all joints of the first right toe and the right medial cuneiform-first metatarsal joint, several from each sacro-iliac joint, one from each sterno-clavicularjoint, one from each of several costo-sternal joints, and several from the manubrio-sternal joint. The spinal column from the ninth thoracic to the third sacral vertebrae was removed at autopsy and blocks were taken from many intervertebral joints, intervertebral disks and the left tenth costo-vertebral joint. Many of the illustrations are taken from this case (Figs 8, 10-14, 16, 18). Only axial joints were involved in the second post-mortem case; the spinal column from T3 to L4, the sternal joints, and the symphysis pubis were examined in detail. The third post-mortem case was that already reported by Freund (1942), many sections from the lumbar vertebrae being available.