[Spondylodiscitis in Bechterew's disease; inflammation or trauma? Description of 6 patients].

OBJECTIVE

To study the prevalence and nature of sterile spondylodiscitis in patients suffering from ankylosing spondylitis.

DESIGN

Descriptive.

SETTING

Department of Rheumatology, Medisch Spectrum Twente, Enschede, the Netherlands.

METHOD

Of all ankylosing spondylitis patients suffering from sterile spondylodiscitis, the medical histories and the radiological and histological findings were analysed.

RESULTS

Among about 400 patients, 6 cases of sterile spondylodiscitis were found; 4 men and 2 women. The mean time lapse between diagnosis of ankylosing spondylitis and onset of spondylodiscitis symptoms was 7 years; in I patient discitis was the first symptom. Discitis changed the nature of the backache: it worsened during exercise and improved on resting. There was no history of trauma. Symptomatic and asyptomatic radiological abnormalities were seen at the same time in 2 patients. Symptoms disappeared 3-36 months after start of conservative treatment. Histological examination was performed in 2 cases and showed inflammatory changes.

CONCLUSION

Spondylodiscitis in ankylosing spondylitis has a highly variable presentation and in general a good prognosis. Our findings support an inflammatory rather than a traumatic pathogenesis.