Syndesmophyte growth in ankylosing spondylitis

Abstract

Purpose of review Syndesmophytes are characteristic components of the spine pathology of ankylosing spondylitis (AS). Understanding their growth may reveal insights to pathogenesis and potential treatment. We review recent studies on rates of development of syndesmophytes, patient characteristics associated with more rapid syndesmophyte growth, local vertebral abnormalities that precede syndesmophytes, systemic biomarkers of syndesmophytes, and studies of medications. Recent findings New syndesmophytes develop in one-third of patients over two years. Consistent clinical predictors are male gender, elevated serum C-reactive protein levels, and pre-existing syndesmophytes. Concomitant vertebral inflammation and fat dysplasia on magnetic resonance imaging predict future syndesmophytes at the same vertebral location, but most syndesmophytes do not have recognized antecedents. Associations with serum levels of Wnt pathway proteins are inconsistent, as are the results of observational studies of tumor necrosis factor-alpha inhibitors. Summary Although there is better understanding of the frequency of syndesmophyte development, the pathogenesis of syndesmophytes remains unclear.

Small leucine rich proteoglycans, a novel link to osteoclastogenesis

“…osteoarthritis, lupus and osteolytic metastatic reaction) 52 , 80 , 81 . One such example is ankylosing spondylitis (AS), which is a chronic inflammatory arthritis, where there is simultaneous destruction and formation of bone and where TNFα has a role in the pathogenesis 82 , 83 . Some of the symptoms of this disease are stiffness and fusion of joints (especially in the vertebrae) and syndesmophyes (a bony growth inside a ligament), features previously reported in the BgnFmod KO mice 43 , 67 , 68 .…”

Clinical practice recommendations for the use of imaging in the diagnosis and management of axial spondyloarthritis in Taiwan

“…Ankylosis of the spine greatly affects AS patients’ daily life, associated with the limitations of physical function and mobility of the spine. Detection of new syndesmophyte formation is considered as the best predictor of radiographic AS disease progression . The progression rate in patients with pre‐existing radiographic syndesmophytes is significantly higher than those without .…”

Effects of weight- and age-related syndesmophytes on patients with ankylosing spondylitis.

“…Worsening of mSASSS score ≥2 was defined as the growth of syndesmophytes which might lead to chronic structural changes of the spine, diminished physical function and restricted spinal motion (25)(26)(27). The diagnosis of syndesmophyte relying on X-ray was evaluated by two radiologists independently and blindly and the final mSASSS score was the average value of the them.…”