A wider spectrum of spondyloarthropathies

Khan, Muhammad Asim; Linden, Sjef M. van der

doi:10.1016/0049-0172(90)90023-9

Cited by 111 publications

(50 citation statements)

References 39 publications

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“…Our findings on the structure and pathology of bone at a large number of entheses offer an explanation for the wide spectrum of target sites in SpA that have been clinically recognized but not conceptualized from a pathophysiologic perspective (16). The extreme paucity of cortical bone at fibrocartilaginous entheses is likely to be of pivotal importance.…”

Section: Discussionmentioning

confidence: 82%

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Microdamage and altered vascularity at the enthesis–bone interface provides an anatomic explanation for bone involvement in the HLA–B27–associated spondylarthritides and allied disorders

Benjamin¹,

Toumi²,

Suzuki³

et al. 2007

Arthritis & Rheumatism

136

106

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Objective. To describe the basis for enthesealassociated bone disease in the spondylarthritides, by analyzing microanatomic and histopathologic relationships between soft tissue, bone cortex, and adjacent trabeculae.Methods. Serial sections from 52 entheses were examined; these entheses encompassed small and large insertions in the upper limb (n ‫؍‬ 21), lower limb (n ‫؍‬ 27), and spine (n ‫؍‬ 4) from 60 cadavers. Enthesis microdamage (fissuring) as well as vascular and reparative changes were evaluated. Contact radiographs were used to ascertain the relationship between entheses and the trabecular network.Results. At virtually all fibrocartilaginous entheses, the deep cortical boundary was extremely thin (typically 50-600 m) or indistinguishable, and 96% of entheses had small holes in the cortical shell (typically 100-400 m wide). Such regions were frequent sites of bone formation and renewal (96%) and microdamage (31%); these changes were more common in the lower limb. The presence of blood vessels near holes in the cortical shell was common; in 85% of attachments, blood vessels were present on the soft tissue side of the enthesis. Highly orientated trabeculae were more obvious in the lower limb than the upper limb (59% versus 29%).Conclusion. The trabecular network supporting the cortical shell is an integral part of the enthesis, transferring load to an extensive skeletal region. In many cases, tendons/ligaments are anchored directly to such networks. This functional integration is associated with microdamage and repair at the hard tissue-soft tissue interface. These findings have implications for understanding bone involvement in SpA and for the SpA concept in general, especially the hypothesis that enthesis-bone architecture may be important in disease initiation.

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Section: Discussionmentioning

confidence: 82%

“…In addition, diffuse osteitis occurs in chronic multifocal recurrent osteomyelitis, which is considered to be closely related to the SAPHO syndrome and SpA (14,15). Thus, the basis for the diffuse bonebased changes that characterize a wide spectrum of related conditions is unclear (16).…”

mentioning

confidence: 99%

Microdamage and altered vascularity at the enthesis–bone interface provides an anatomic explanation for bone involvement in the HLA–B27–associated spondylarthritides and allied disorders

Benjamin¹,

Toumi²,

Suzuki³

et al. 2007

Arthritis & Rheumatism

136

106

View full text Add to dashboard Cite

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“…On the other hand, the clinical spectrum of SpA has been recently expanded and has included the clinical disorders without any involvement of the axial skeleton. In addition to AS, a prototype of SpA, reactive arthritis (including Reiter's syndrome), arthritis associated with chronic inflammatory bowel disease, psoriatic arthritis, undifferentiated SpA, and a subgroup of juvenile chronic arthritis have been comprised in the SpA complex (1,6,12). However, the inclusion of BD into this disease entity is still debatable.…”

Section: Discussionmentioning

confidence: 99%

The Comparison Between Behcet's Disease and Spondyloarthritides: Does Behcet's Disease Belong to the Spondyloarthropathy Complex?

et al. 2002

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This study was to clarify whether Beh et's disease (BD) could be classified into the spondyloarthropathy (SpA) complex. It was undertaken on 58 patients with BD (BD group), 56 patients with SpA (SpA group), and 3 patients who concurrently satisfied the criteria for BD and SpA (BDSpA group). The clinical parameters and known susceptible HLA antigens were compared between BD group and SpA group. In addition, 3 patients in BDSpA group were reviewed. The prevalence of definitive sacroiliitis (SI) in BD group and SpA group was 46.4% and 5.2%, respectively. However, none had a definitive SI in healthy controls. Enthesitis was observed in 3.4% of BD group and in 50% of SpA group. The patterns of eye involvement were different between these two groups. HLA-B27 was negative in all 49 patients of BD group, whereas it was positive in 67.9% of SpA group. The prevalence of HLA-B51 was 51.7% in BD group, and that in SpA group was 21.4%. One patient in BDSpA group was considered to have concurrent BD and ankylosing spondylitis (AS). Another patient was closer to AS, and the third to BD. Conclusively, it seems that BD could not be classified into the SpA complex.

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“…Khan и S. van der Linden [4], предлагая критерии Европейской группы по изучению СпА (ESSG) и говоря о расширении спектра СпА, предполагали многообразие как форм СпА, с учетом всех недифференцированных и перекрестных вариантов, так и клинических проявле-ний, когда наряду со спондилитом и артритом присутству-ют увеит, аортит, колит и т. д.…”

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The Frequency and Severity of Extraskeletal Manifestations of Ankylosing Spondylitis

Годзенко¹,

Бочкова²,

Румянцева³

et al. 2017

rsp

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A wider spectrum of spondyloarthropathies

Cited by 111 publications

References 39 publications

Microdamage and altered vascularity at the enthesis–bone interface provides an anatomic explanation for bone involvement in the HLA–B27–associated spondylarthritides and allied disorders

Microdamage and altered vascularity at the enthesis–bone interface provides an anatomic explanation for bone involvement in the HLA–B27–associated spondylarthritides and allied disorders

The Comparison Between Behcet's Disease and Spondyloarthritides: Does Behcet's Disease Belong to the Spondyloarthropathy Complex?

The Frequency and Severity of Extraskeletal Manifestations of Ankylosing Spondylitis

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