One hundred fifty war veterans with ankylosing spondylitis were entered into a prospective study in 1947. In 1957, 142 were traced, and they have been reviewed periodically. Eighty‐one of these patients were still alive in 1980. Information was obtained from 67 (83%) of the survivors and 51 were reexamined. This report is based on the clinical findings in these 51 patients, who have a mean disease duration of 38 years. Forty‐seven (92%) were functioning well. The disease in 21 (41%) had progressed to cause severe spinal restriction. Of those, 12 had peripheral joint involvement early in their course and 9 had iritis. Seventy‐four percent of the patients who had mild spinal restriction after 10 years did not progress to having more severe restriction. Eighty‐one percent of the patients who had severe spinal restriction in 1980 were severely restricted within the first 10 years. Hips that were normal after 10 years of disease did not become diseased subsequently. This study suggests that a predictable pattern of ankylosing spondylitis emerges within the first 10 years of the disease.
Six patients with ankylosing spondylitis were found to have asymptomatic spondylodiscitis. They have been followed for a mean of 17 years and have been free of symptoms or complications from this lesion. This benign asymptomatic course has not been stressed by previous authors.Erosive sclerotic lesions of the vertebral bodies surrounding a disc (spondylodiscitis) are not uncommon in ankylosing spondylitis. In a prospective study of 128 patients, there were six such lesions after 17 years (1). This is an incidence of 5% and agrees with the 6% incidence reported by Shulitz in his series (2).In a recent detailed study of this lesion 15 patients presented with localized back pain. Thirteen had local tenderness and 11
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