Asymptomatic spondylodiscitis an unusual feature of ankylosing spondylitis

Abstract

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

Spinal Pseudarthrosis in Advanced Ankylosing Spondylitis With Sagittal Plane Deformity

“…In the present study, we sought to correlate clinical and laboratory findings with traumatic, inflammatory, or mechanical etiologies. 4,5,11 Traumatic events that preceded the development of destructive disco-vertebral lesions were only reported by 4 of the 12 patients. Increased systemic inflammatory responses, including elevation of ESR and CRP, were found in 5 patients.…”

Spondylodiscitis and ankylosing spondylitis: HLA typing and nosological implications.

“…Recently, Daneo and Di Vittorio (1970) and Little et al (1974) have stressed the precocious occurrence in some AS patients of primary spondylodiscitic lesions at multiple levels, in the absence of classical spinal syndesmophytosis. These latter findings, together with the tendency for voluminous intervertebral bony bridges to form, have suggested a different pathogenetic mechanism for this particular type of spondylodiscitis.…”

“…There is no agreement about the origin of these lesions, some authors favouring traumatic (Kanefield et al, 1969;Rivelis and Freiberger, 1969;Cawley et al, 1972;Gougeon et al, 1977), others inflammatory mechanisms (Romanus and Yden 1952;Coste et al, 1963;Little et al, 1974 (Gofton, 1968) 9 subjects (14%) had radiological signs of SD. These 9 patients, together with their available first-degree relatives (>16 years of age)-2 parents, 3 sibs, and 3 children-underwent clinical and radiological investigation.…”

“…There is no agreement about the origin of these lesions, some authors favouring traumatic (Kanefield et al, 1969;Rivelis and Freiberger, 1969;Cawley et al, 1972;Gougeon et al, 1977), others inflammatory mechanisms (Romanus and Yden 1952;Coste et al, 1963;Little et al, 1974). In the most destructive lesions, often occurring in the late stages of AS at only one vertebral metamer, namely at the hinge-point between two ankylosed spinal segments, the traumatic mechanism is likely.…”

Discovertebral lesion in ankylosing spondylitis: differential diagnosis with discitis by magnetic resonance imaging

“…The main symptoms of discovertebral lesions are pain and stiffness of the spinal column, although some are asymptomatic. 6 Histological descriptions may vary, 7 but generally the lesion is composed of necrotic bone and granulation tissue compatible with pseudoarthrosis. 8,9 Some reports support the theory that these lesion are traumatic in origin, 5,8,10 and some support an atraumatic origin.…”