Do the radiological changes of classic ankylosing spondylitis differ from the changes found in the spondylitis associated with inflammatory bowel disease, psoriasis, and reactive arthritis?
Do the radiological changes of classic ankylosing spondylitis differ from the changes found in the spondylitis associated with inflammatory bowel disease, psoriasis, and reactive arthritis?
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DOI：
10.1136/ard.57.3.135
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发表时间：
1998-03-01
影响因子：
27.4
通讯作者：
Wright, V
中科院分区：
文献类型：
--
作者：
Helliwell, PS;Hickling, P;Wright, V
目的-1971年，McEwen及其同事提出，经典强直性脊柱炎(AS)的放射学改变以及炎症性肠病相关的脊柱炎的改变在几个方面不同于银屑病和反应性脊柱炎的放射学特征。这项研究的结果从未得到证实。这项研究的目的是复制McEwen的研究，将电影与诊断组进行盲法比较。方法-研究人群包括91名典型强直性脊柱炎患者，15名区域性肠炎患者，16名溃疡性结肠炎患者，5名性获得性反应性关节炎患者，2名痢疾后关节炎患者，34名牛皮癣关节炎患者。对脊柱X线片进行盲读，对严重程度、对称性、椎旁骨化、关节突大小、韧带钙化、方块、椎间隙炎、假性骨折、关节突关节受累和完全性关节僵硬进行评分。结果：经典型、肠病、银屑病和反应性强直四组之间在骶髂炎对称性、腰椎受累对称性、关节突发生率和大小方面存在差异。腰椎关节突关节受累在经典型脊柱炎和肠病性脊柱炎中更为常见，但在交界炎、直立性方面没有发现组间差异。结论：McEwen等人描述的银屑病的一些放射学差异已得到证实，尤其是银屑病的不对称性、较轻的改变和明显的关节突起。提出了许多假说来解释这些差异，包括生物力学、生化和遗传因素。
Objective-In 1971 McEwen and colleagues suggested that the radiological changes of classic ankylosing spondylitis (AS), and the changes of the spondylitis associated with inflammatory bowel disease differ in several respects from the radiological features of psoriatic and reactive spondylitis. The findings of this study have never been confirmed. The aim of this study was to replicate the McEwen study comparing films blinded to diagnostic group.Methods-The study population comprised 91 patients with classic AS, 15 patients with regional enteritis, 16 patients with ulcerative colitis, five patients with sexually acquired reactive arthritis, two with post-dysenteric arthritis, and 34 with psoriatic arthritis. Blinded reading of spinal radiographs was undertaken, scoring for severity, symmetry, paravertebral ossification, size of syndesmophytes, ligamentous calcification, squaring, discitis, pseudofractures, zygoapophyseal joint involvement, and complete ankylosis.Results-Comparison of the four groups-classic, enteropathic, psoriatic, and reactive AS-showed differences with respect to symmetry of sacroiliitis, symmetry of lumbar spinal involvement, and frequency and size of syndesmophytes. Zygoapophyseal joint involvement was more frequent in the lumbar spine in classic and enteropathic spondylitis but no between group differences were found with respect to symphisitis, squaring. apophyseal joint involvement and ligamentous calcification in the lumbar spine, and other areas.Conclusions-Some of the radiological differences described by McEwen et al, notably the asymmetry, the less severe changes, and the distinctive syndesmophytes in psoriasis, have been confirmed. A number of hypotheses are proposed to explain these differences including biomechanical, biochemical, and genetic factors.