Associate Clinical Professor of Rheumatology and Internal Medicine at UCLA and Cedars Sinai Medical Center
Forouzesh et al. on:
The Clinical Spectrum of Ankylosing Spondylitis
Solomon Forouzesh, M.D., and Rodney Bluestone, M.D., M.R.C.P.
Introduction
Ankylosing Spondylitis (A) is known to have afflicted mankind from ancient times. Characteristic bony changes involving the entire vertebral column from the coccyx to the upper cervical region have been found in the Egyptian mummies, and clear descriptions of the disease are recorded in the literature dating back to the 17th century.
In the past, numerous names have been assigned to the disease, but the current term is most generally accepted. More recently our knowledge about this rheumatic disorder has grown significantly, and studies of patients with AS have produced some of the more remarkable new developments in the entire field of scientific rheumatology.
For the purpose of diagnosis or disease classification, physicians have anecdotally grouped patients with various clinical presentations recognizable as fairly discrete rheumatic syndromes. These clinical syndromes include: AS, AS associated with inflammatory bowel disease, juvenile AS, Reiter's syndrome, and psoratic arthropathy. In addition there may be a large pool of subclinical or"form fruste" disease in which sacroilitis and spondytis are preceded or masked by a more obvious extra-skeletal manifestation such as uveitis. The detection of HLA-B27 in such individuals has served to broaden our recognition of all the spondylitis syndromes.
