Abstract
Some of the causes of inflammatory spondylitis are described and their radiological differentiation discussed. These appearances are compared and contrasted with the hyperostoses of non-inflammatory spondylosis.
The classical appearance of Marie-Strümpell ankylosing spondylitis is shown to be virtually indistinguishable from colitic spondylitis, except perhaps in degree. Spondylitis associated with psoriasis and Reiter's disease, however, presents a different pattern.
The hyperostosis of hypophosphatemic osteomalacia may simulate ankylosing spondylitis and has led to misdiagnosis. Similarity is noted also between the non-inflammatory hyperostoses, particularly in the appendicular skeleton, including primary hypoparathyroidism and Forestier's spinal hyperostosis (diffuse idiopathic skeletal hyperostosis).
Similar content being viewed by others
References
Ansell, B.M.: The cervical spine in juvenile rheumatoid arthritis. In: Radiological Aspects of Rheumatoid Arthritis (Ed. M.E. Carter). International Congress Series No. 61, p. 233. Amsterdam: Excerpta Medica Foundation 1964
Ball, J.: Enthesopathy of rheumatoid and ankylosing spondylitis. The Heberden Oration, 1970. Ann. rheum. Dis. 30, 213 (1971)
Bywaters, E.G.L., Ansell, B.M.: Arthritis associated with ulcerative colitis: a clinical and pathological study. Ann. rheum. Dis. 17, 169 (1958)
Bywaters, E.G.L., Dixon, A.St.J.: Paravertebral ossification in psoriatic arthritis. Ann. rheum. Dis. 23, 313 (1965)
Clarke, R.L., Muhletaler, C.A., Margulies, S.I.: Colitic arthritis. Radiology 101, 585 (1971)
Forestier, J., Lagier, R.: Ankylosing hyperostosis of the spine. Clin. Orthop. 74, 65 (1971)
Hollander, J.L. (Ed.): Arthritis and Allied Conditions. 7th Ed. Philadelphia: Lea and Febiger 1966
Jalan, K.N., Prescott, R.J., Walker, R.J., Sircus, W., McManus, J.P.A., Card, W.I.: Arthropathy, ankylosing spondylitis and clubbing of fingers in ulcerative colitis. Gut 11, 748 (1970)
McEwen, C.: Arthritis accompanying ulcerative colitis. Clin. Orthop. 57, 9 (1968)
McEwen, C., DiTata, D., Lingg, C., Porini, A., Good, A., Rankin, T.: Ankylosing spondylitis and spondylitis accompanying ulcerative colitis, regional enteritis, psoriasis and Reiter's disease. Arthritis Rheum. 14, 291 (1971)
Macnab, I.: The traction spur-an indicator of segmental instability. J. Bone Jt Surg. 53A, 663 (1971)
Niepel, G.A., Kostka, D., Kopecky, S., Manca, S.: Enthesopathy. Acta rheum. balneol. Pistiniana No. 1 (1966)
Patton, J.T.: Hip changes in metabolic bone disease Proc. Roy. Soc. Med. 59, 1231 (1966)
Peacock, E.E., Jr.: A study of the circulation in normal tendons and healing grafts. Ann. Surg. 149, 415 (1959)
Rathbun, J.B., Macnab, I.: The micro-vascular pattern of the rotator cuff. J. Bone Jt Surg. 52-B, 540 (1970)
Resnick, D., Shaul, S.R., Robins, J.M.: Diffuse idiopathic skeletal hyperostosis (DISH): Forestier's disease with extraspinal manifestations. Radiology 115, 513 (1975)
Sundaram, M., Patton, J.T.: Paravertebral ossification in psoriasis and Reiter's disease, Brit. J. Radiol. 48, 628 (1975)
Vernon-Roberts, B., Pirie, C.J., Trenwith, V.: Pathology of the dorsal spine in ankylosing hyperostosis. Ann. rheum. Dis. 33, 281 (1974)
Zvaifler, N.J., Martel, W.: Spondylitis in chronic ulcerative colitis. Arthritis Rheum. 3, 76 (1960)
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Patton, J.T. Differential diagnosis of inflammatory spondylitis. Skeletal Radiol. 1, 77–85 (1976). https://doi.org/10.1007/BF00347412
Issue Date:
DOI: https://doi.org/10.1007/BF00347412