Simultaneous presentation of upper lobe fibrobullous disease and spinal pseudarthrosis in a patient with ankylosing spondylitis

Article Abstract:

Ankylosing spondylitis is a chronic, progressive disease involving the joints in the vertebrae and pelvis, and is associated with sclerosis (thickening) of the joint, as well as changes in the joint that are characteristic of rheumatoid arthritis (RA). Symptoms of RA include inflammation, stiffness, swelling, overgrowth of cartilage tissue, and pain. The terms to be used to describe the lesions developing on the vertebrae in ankylosing spondylitis have not been clearly established. The term spinal pseudarthrosis refers to a destructive vertebral lesion in the upper and middle portion of the back, which leads to extensive bone deterioration. Spondylodiscitis refers to the eburnation of the disc and end-plate portions of the vertebrae, in which the bone becomes progressively more dense and hard. Spondylodiscitis develops in the early inflammatory phase of ankylosing spondylitis. Ankylosing spondylitis is also associated with upper lobe fibrobullous disease, which is characterized by the formation of fibrous, blister-like lesions in the upper portions of the lung. This complication of ankylosing spondylitis resembles tuberculosis, an infectious disease. A case is described of a 51-year-old man with a 20-year history of ankylosing spondylitis and a hunch-back appearance. His condition was complicated by upper lobe fibrobullous disease and spinal pseudarthrosis. The patient did not have nerve-related complications and was treated with conservative measures. Both complications resemble tuberculosis and occur in patients with prolonged ankylosing spondylitis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Lung diseases, Joint diseases, Pseudarthrosis

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Pulmonary function and maximal transrespiratory pressures in ankylosing spondylitis

Article Abstract:

Ankylosing spondylitis is a long-term progressive disease of the vertebrae, the bony segments of the spine. The changes in joint structure resemble those found in rheumatoid arthritis, an inflammatory joint disease. Ankylosing spondylitis is associated with a reduction in the volume of the lungs, probably resulting from a decrease in the mobility of the thoracic portion of the skeleton surrounding the chest. However, little is known about the strength of the respiratory or breathing muscles in ankylosing spondylitis. Respiratory muscle function and strength were assessed in 30 patients with ankylosing spondylitis by measuring lung volumes and pressures. The vital capacity (VC) is the greatest amount of air that can be expired after maximum inspiration and is a measure of lung function. VC was decreased to 79 percent, whereas forced expiratory volume or amount of air expelled by breathing out forcibly was reduced to 82 percent. The total lung capacity was reduced to 85 percent, and decreased lung volumes correlated well with clinical measurements. The maximal expiratory and inspiratory pressures were reduced to 56 and 76 percent, respectively. These findings suggest that in ankylosing spondylitis, lung volumes are less affected than respiratory muscle strength, which may be reduced as a result of atrophy or wasting away of the intercostal muscles used in breathing. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Respiration

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Clearance of inhaled particles in ankylosing spondylitis

Article Abstract:

Ankylosing spondylitis (AS) is the inflammation of the vertebrae, the bony segments of the spine, and may affect other body sites such as the lung, heart, and nerves. Patients with AS may rarely develop apical fibrobullous lung disease, the formation of fiber-like blisters on the top portion of the lung; the cause is unknown. It has been suggested that the rigidity of the thoracic (rib) cage, the portion of the skeleton surrounding the chest area, results in decreased clearance of inhaled particles from the apical or top portion of the lung. This may lead to chronic or long-term infection. The distribution and clearance of inhaled radioactive sulphur particles were assessed in eight male patients with AS and rigid chest walls but normal X-rays, and eight healthy males. The particles were distributed from the apex to the base of the lung in both patients and normal subjects. The elimination of the particles was not delayed in patients with ankylosing spondylitis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Lungs, Lung

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