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Abstract
SummaryAnkylosing spondylitis is a chronic disease of insidious onset starting
usually in males between ages of 10 and 40 years. Ankylosing spondylitis is
three times more frequent in men than in women. It commonly involves the
sacroiliac and lower spinal joints and less frequently other large joints such as
the hips, knees and ankles as well as the entheses. The etiology may be a crossreaction
by antibodies for certain bacteria in individuals with the HLA-B27
gene. The basic pathologic lesion of ankylosing spondylitis occurs at the
entheses, which are sites of attachment to bone of ligaments, tendons, and joint
capsules. Typically, bilateral and symmetric changes in the three compartments
of the knee (medial femorotibial, lateral femorotibial, patellofemoral
compartments) include effusions, osteoporosis, and joint space narrowing.
Additional manifestations are marginal erosions, subchondral cysts, and juxtaarticular
periostitis. Intra-articular bone fusion also is reported.
Common symptoms of Ankylosing Spondylitis start out as recurrent
lower back pain in the lumbar and sacroiliac areas for longer than three months
with swelling around the sacroiliac joints . although it can start in the peripheral
joints in the form of swelling of joints causing a stiff, painful movement which
is especially worse during periods of inactivity. In approximately 30 per cent of
patients with ankylosing spondylitis of long duration, radiographic abnormalities
appear in the knees. MRI was able to detect inflammatory and destructive
changes of the joints in spondylitis. accurate diagnosis depends on clinical and
radiologic investigations.