In order to establish how many children with seronegative spondyloarthropathy (SpA) starting with peripheral arthritis and/or enthesitis will develop ankylosing spondylitis (AS), 13 consecutive Caucasian pediatric patients, (11 with the seronegative enthesopathy and arthropathy (SEA) syndrome and 2 with isolated B27 associated peripheral arthritis or enthesitis at entry), were followed prospectively with no loss for more than 5 years. Sacroiliac joint plain films obtained at the last visit were mixed with those of 14 control subjects and read blindly. The course of SpA was self-limiting in 6 patients and recurrent in the other 7. Six patients had episodes of inflammatory cervical and/or lumbar pain during followup. However, none showed any limitation of spinal movement in the asymptomatic periods. Only one patient (9.1%) of 11 with the SEA syndrome showed bilateral sacroiliitis and met New York criteria for AS after 5 years of disease. Our results suggest that the proportion of Caucasian children with the SEA syndrome developing AS is much lower than the 75% found in a similar study on Mexican children. Lack of evaluation of all patients after 5 years, the reading of pelvic plain films without reducing observer error, and the male predominance in the Mexican study, probably in addition to ethnic or environmental factors, may account for differences.

Three more cases of B27-positive patients who developed peripheral arthritis immediately after trauma are reported. The first had an exacerbation of arthritis in the right hip after falling from her motor-bike. The second had arthritis of the distal interphalangeal (DIP) joint of the right forefinger after shutting his finger in the door of his car. The third had arthritis of the right sternoclavicular joint after a road-accident while fastening her safety belt.

Arthritis & RheumatismVolume 34, Issue 6 p. 788-789 LetterFree to Read Transcutaneous electrical nerve stimulation in ankylosing spondyitis: A double-blind study Gabriele Gemignani MD, Gabriele Gemignani MD University of Pisa, Pisa, ItalySearch for more papers by this authorIgnazio Olivieri MD, Ignazio Olivieri MD University of Pisa, Pisa, ItalySearch for more papers by this authorGiusta Ruju MD, Giusta Ruju MD University of Pisa, Pisa, ItalySearch for more papers by this authorGiampiero Pasero MD, Giampiero Pasero MD University of Pisa, Pisa, ItalySearch for more papers by this author Gabriele Gemignani MD, Gabriele Gemignani MD University of Pisa, Pisa, ItalySearch for more papers by this authorIgnazio Olivieri MD, Ignazio Olivieri MD University of Pisa, Pisa, ItalySearch for more papers by this authorGiusta Ruju MD, Giusta Ruju MD University of Pisa, Pisa, ItalySearch for more papers by this authorGiampiero Pasero MD, Giampiero Pasero MD University of Pisa, Pisa, ItalySearch for more papers by this author First published: June 1991 https://doi.org/10.1002/art.1780340624Citations: 32AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume34, Issue6June 1991Pages 788-789 RelatedInformation

In order to evaluate the prevalence of audiovestibular disturbances in Behçet's syndrome, we submitted 20 consecutive patients and 20 control subjects to detailed audiologic and vestibular examination in the last 3 years. A sensorineural hearing loss was found in 12 patients, 2 of whom revealed sudden deafness. Two other patients with neuro-Behçet's syndrome showed a vestibular function deficit, and 3 others exhibited altered caloric stimulation test results. Two of these last patients also revealed a simultaneous bilateral auditory deficit. HLA typing showed the presence of the B51 antigen in 10 of the 14 patients with ear involvement, while only 3 of the 6 patients without ear involvement were HLA-B51-positive. Results suggest that audiovestibular involvement is common in Behçet's syndrome: Sudden deafness may be the first sign of ear disturbance; vestibular lesions may represent an early sign of neuro-Behçet's syndrome; and the HLA-B51 antigen is associated with ear involvement. Otoneurologic study can reveal hidden brain stem lesions in Behçet's patients during flare-ups of the disease, even without obvious signs of neurologic deficits.

Sacroiliitis of seronegative spondyloarthropathy may sometimes show on pelvis plain films findings indistinguishable from those of osteitis condensans ilii. Computed tomography (CT) can differentiate earlier than plain radiography between the 2 conditions; furthermore, it should also be possible to make this differentiation clinically. The aim of our study was to verify whether the criteria recently proposed by the European Spondylarthropathy Study Group (EESG) for the classification of spondyloarthropathy are useful. CT scans through the synovial part of the sacroiliac joints of 7 consecutive patients meeting the ESSG criteria and showing typical findings of osteitis condensans ilii on plain films were mixed with those of 15 consecutive patients with osteitis condensans ilii not meeting the ESSG criteria. Scans were examined for joint space and surface abnormalities blindly and independently by 2 observers. Six patients in the spondyloarthropathy group and one in the osteiitis condensans ilii group showed clear erosions and/or joint space narrowing of less than 2 mm in at least one joint. The difference was statistically significant (p less than 0.001). Our results suggest that by using criteria valid for the whole group of seronegative spondyloarthropathies, it is possible to differentiate clinically between seronegative spondyloarthropathies with sacroiliitis mimicking osteitis condensans ilii and "true" osteitis condensans ilii.

Journal Article Behçet's Syndrome and Spondyloarthritis Get access I. OLIVIERI, I. OLIVIERI Rheumatic Disease Unit, Institute of Medical Pathology, and Institute of Radiology, University of PisaPisa, Italy Search for other works by this author on: Oxford Academic PubMed Google Scholar G. GEMIGNANI, G. GEMIGNANI Rheumatic Disease Unit, Institute of Medical Pathology, and Institute of Radiology, University of PisaPisa, Italy Search for other works by this author on: Oxford Academic PubMed Google Scholar G. BRACCINI, G. BRACCINI Rheumatic Disease Unit, Institute of Medical Pathology, and Institute of Radiology, University of PisaPisa, Italy Search for other works by this author on: Oxford Academic PubMed Google Scholar G. PASERO G. PASERO Rheumatic Disease Unit, Institute of Medical Pathology, and Institute of Radiology, University of PisaPisa, Italy Search for other works by this author on: Oxford Academic PubMed Google Scholar Rheumatology, Volume 29, Issue 5, October 1990, Pages 409–410, https://doi.org/10.1093/rheumatology/29.5.409 Published: 01 October 1990 Article history Received: 23 May 1990 Published: 01 October 1990

In order to reduce the subjective factor in evaluating sacroiliac joint radiographs we further evaluated changes seen on standard plain films of patients suffering from Behçet's syndrome (BS) by using computed tomography (CT). Sacroiliac joint films of 20 consecutive patients with BS were mixed with those of 20 consecutive control patients and read blindly and independently by two observers. Six patients with BS met the New York criteria for sacroiliitis. Of the control patients, one had monolateral grade 1 sacroiliitis and two revealed findings consistent with osteitis condensans ilii. CT confirmed the diagnosis of sacroiliitis in patients with BS showing a high degree in at least one joint. The results of the present study suggest that the use of CT for BS patients showing sacroiliac joint changes on pelvic plain films may limit the confusion which exists about this finding in BS.

The case of a 59-year-old man with definite HLA B27 negative ankylosing spondylitis (AS) and Paget's disease involving the skull, the right side of the pelvis and the proximal femur is reported. Fifteen cases with this coexistence have previously been described. Some of these, however, are patients with Paget's disease mimicking AS. It is emphasized again that attention must be paid to diagnosing AS in patients suffering from Paget's disease.

The case is reported of a 42 year old white woman meeting currently used diagnostic criteria for both ankylosing spondylitis and systemic lupus erythematosus (SLE). As found in a previously described similar case of a black man, HLA typing showed antigens associated with both SLE and seronegative spondyloarthropathy. This case thus supports the hypothesis that the two diseases occur together only when this rare combination of HLA antigens is present.

We report the case of a man with ankylosing spondylitis involving the symphysis pubis and some intervertebral discs in addition to the sacroiliac joints. The bone adjacent to each inflammatory area showed an unusually exuberant sclerosis. In the early phases of evolution the appearance of sacroilitis was indistinguishable from that of osteitis condensans ilii.

A propos d'un homme de 42 ans souffrant d'enthesites erosives bilaterales des talons. Atteinte concommittante des entheses des tuberosites ischiatiques, du grand trachanter et de la tete du perone

Two more cases of B27 associated peripheral arthritis triggered by physical injury are reported. One patient developed arthritis after a minor insult and in the other Reiter's syndrome occurred after the injury. Possibly, trauma causes release of self antigens from the injured joints.

Behçet's disease is a multisystemic vasculitis of unknown aetiology. Generally, it is characterized by recurrent aphthous stomatitis, recurrent genital ulcers, uveitis with hypopion. Recently some authors reported that patients with Behçet's disease show frequently audio-vestibular involvement. We observed a 40 year-old man (case A) and a 66 year-old woman (case B) affected by Behçet's disease for more than 10 years, showing a sudden deafness occurring during an exacerbation of the disease. In both cases there was a sensorineural hearing-loss, unilateral or bilateral. One patient received early high-dose cortisone therapy. General symptoms and audiovestibular function, both have completely recovered.