• Title/Summary/Keyword: Spondylitis

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Non-cirrhotic portal hypertension in an ankylosing spondylitis patient

  • Park, Sukki;Lee, Ji Hyun;Choi, Joon Sul;Kim, Hyun Woo;Shim, Beom Jin;Choi, Won Kyu;Kim, Sang Hyun
    • Journal of Yeungnam Medical Science
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    • v.35 no.1
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    • pp.89-93
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    • 2018
  • Idiopathic non-cirrhotic portal hypertension (INCPH) is a disease with an uncertain etiology consisting of non-cirrhotic portal hypertension and portal pressure increase in the absence of liver cirrhosis. In INCPH, patients exhibit normal liver functions and structures. The factors associated with INCPH include the following: Umbilical/portal pyremia, bacterial diseases, prothrombic states, chronic exposure to arsenic, vinyl chloride monomers, genetic disorders, and autoimmune diseases. Approximately 70% of patients present a history of major variceal bleeding, and treatment relies on the prevention of complications related to portal hypertension. Autoimmune disorders associated with INCPH are mainly systemic sclerosis, systemic lupus erythematosus and rheumatoid arthritis. To the best of our knowledge, a case of ankylosing spondylitis (AS) associated with INCPH has not been reported thus far. Therfore, we report our experience of a patient with AS accompanied by INCPH, who showed perisplenic varices with patent spleno-portal axis and hepatic veins along with no evidence of cirrhosis on liver biopsy, and provide a brief literature review.

Delayed Postoperative Paravertebral Abscess in a Patient with Cervical Spinal Cord Injury Accompanied by Ankylosing Spondylitis (강직성 척수염이 있는 경수 손상 환자에서 발생한 지연성 척추주위 농양)

  • Lee, Geon Jae;Lee, Jang Woo
    • Clinical Pain
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    • v.20 no.2
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    • pp.145-149
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    • 2021
  • Ankylosing spondylitis (AS) is a chronic inflammatory disease presenting progressive spinal stiffness and sacroiliitis. Cervical spine fracture combined with AS should be treated with operation, but it is closely related with increased rates of surgical site infection, which are associated with an elevated erythrocyte sedimentation rate and elevated C-reactive protein. We report a case of delayed postoperative infection appeared in cervical paravertebral space, which was masked by laboratory findings and clinical characteristics represented in this rheumatic disease. A 53-year-old man who had medical history of AS got operation after cervical spine fracture. During hospitalization, he experienced aching pain originating from left posterior neck to shoulder, which was revealed out to be delayed postoperative infection, diagnostically obscured by elevated values of inflammatory markers. This case emphasizes detailed evaluation considering symptoms and comorbidity of the patient should be performed to apply proper management.

Experiential treatment of ankylosing spondylitis using Ortho-Cellular Nutrition Therapy (OCNT)

  • Baek, Kyungsin
    • CELLMED
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    • v.12 no.3
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    • pp.14.1-14.2
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    • 2022
  • Currently, a 70-year-old woman started suffering from S.I joint pain from 1973 and had severe pain in the S.I joint, wrist, and elbow from 1975 to 1977, and was diagnosed with spinal tuberculosis at a general hospital. From 1978 to 1987, she suffered from chronic fatigue and insomnia, and since January 1, 1988, she was unable to get up while lying down, suffering from whole body joint, muscle pain, and fibromyalgia. In May 1989, she was also diagnosed with ankylosing spondylitis through genetic testing at the Catholic St. Mary's Hospital Rheumatology Department in Korea, and was treated with sulfasalazine, analgesic, and immunosuppressant, methotrexate, for 12 years until 1999, but none of the drugs eliminated the pain. She was hospitalized and discharged repeatedly, and continued to receive salt water poultice and exercise therapy at home, but was unable to move at all. In 2000, after biologic treatment with Remicade injection (Remsima®), she was able to walk and move, and after that, she was continuously prescribed biologics. From 2015 to 2019, Enbrel® (Etanercept) injection was prescribed once a week, but the symptoms such as severe pain (joint and muscle, fibromyalgia), scleroderma, Sjogren's syndrome (dryness of eyes, nose and mouth), difficulty swallowing, chronic fatigue, and stiff body appeared. Around January 2018, hepatic indicators were high and lymphocytes became enlarged. However, most serious injuries were highly improved after the OCNT combination therapy using active phytonutrients, anthocyanin-fucoidan nanocomplex. Therefore, for patients with such experiences, OCNT treatment is proposed as an alternative.

Rapid Functional Enhancement of Ankylosing Spondylitis with Severe Hip Joint Arthritis and Muscle Strain (고관절염과 근 긴장을 동반한 강직성 척추염의 빠른 기능 회복)

  • Hwang, Sangwon;Im, Sang Hee;Shin, Ji Cheol;Park, Jinyoung
    • Clinical Pain
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    • v.18 no.2
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    • pp.121-125
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    • 2019
  • Arthritis of hip joints deteriorates the quality of life in ankylosing spondylitis (AS) patients. Secondary to the articular inflammatory process, the shortened hip-girdle muscles contribute to the decreased joint mobility which may lead to the functional impairment. As the limitation of range of motion (ROM) usually progress slowly, clinicians regard it as a chronic condition and prescribe long-term therapy. However, by short-term intensive multimodal treatment, a 20-year-old man diagnosed as AS with severely limited hip joint ROM who relied on crutches doubled the joint angle and could walk independently only within 2 weeks. The combination included intra-articular steroid injection, electrical twitch obtaining intramuscular stimulation, extracorporeal shock wave therapy, heat, manual therapy, and stretching exercises. The management focused on the relaxation of hip-girdle muscles as well as the direct control of intra-articular inflammation. Hereby, we emphasize the effectiveness of intensive multimodal treatment in improving the function even within a short period.

Clinical Evaluation of Surgical Treatments for Ten Cases of Tuberculous Spondylitis (결핵성 척추염 10례의 수술적 치료에 관한 임상적 고찰)

  • Whee, Sung Mock;Eoh, Whan;Nam, Do Hyun;Lee, Jung Il;Kim, Jong Soo;Hong, Seung-Chyul;Shin, Hyung Jin;Park, Kwan;Kim, Jong-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.11
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    • pp.1314-1319
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    • 2001
  • Objects : Because of the nonspecific nature of symptoms in tuberculous spondylitis, a delay in the diagnosis can result in progressive neurologic deficits. The authors evaluate the clinical and the radiological results of the 10 cases of surgically treated tuberculous spondylitis. Clinical materials & Methods : We retrospectively analyzed the medical records of 10 patients with tuberculous spondylitis who were treated between February 1996 and March 2000. Six patients were female, and four were male. Mean age was 43 years old, and mean follow-up period was 20.5 months. All patients were treated with 12 months of antituberculous medication postoperatively, and were followed by complete blood count, ESR, spine X-ray and MRI. Results : The lumbar spine was involved in 5 patients, the thoracic in 4, and the thoracolumbar in one. The infected vertebral bodies were 2.8 in average. The associated lesions were pulmonary tuberculosis in 3 cases, and renal tuberculosis in one. Five patients were treated by anterior debridement and fusion with bone graft using anterior instrumentation, 2 with anterior debridement and fusion with bone graft(Hong Kong procedure only), 1 with Hong Kong procedure with posterior spinal instrumentation, and 2 were managed with posterior debridement and posterior spinal instrumentation. All patients improved after operation, and the average kyphotic angle decreased postoperatively. Postoperatively, one patient had a fistula at the operative site. Conclusion : The debridement and minimal level fusion of motion segment with instrument fixation is one of surgical option for tuberculous spondyltis to preserve the spine motion segment as much as possible. Spine instability and kyphosis were prevented by anterior and posterior spinal instrumentation. But, large number of cases and longer period follow-up study in future will be needed to confirm the long term results.

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Pain, Family Support and Quality of Life in Patients with Ankylosing Spondylitis (강직성 척추염 환자의 통증, 가족지지와 삶의 질과의 관계)

  • 임현자;문영임
    • Journal of Korean Academy of Nursing
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    • v.28 no.2
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    • pp.329-343
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    • 1998
  • This study was designed to identify the relationship between perceived pain, family support and quality of life in patients with ankylosing spondylitis. The purpose of this study was to contribute to the theoretical understanding of the relationship of these three variables and eventually to more effective adaptation of patients to their situation. The subjects for this study were the 68 patients who had been diagnosed with ankylosing spondylitis and registered as out-patients in the Rheumatism Center of one university hospital in Seoul. The data were collected during the period from October 10, 1997 to December 20, 1997, Pain was measured using the perceived pain scale(VAS : Visual Analog Scale)developed by Calm(1993), family support using the scale developed by Kang Hyun Suk (1985) and Quality of Life using the scale developed by Ro Yoo Ja(1988). The data were analyzed by descriptive statistics, Frequencies, Pearson correlation coefficient, using the SPSS program. The results of this can be summarized as followings. 1. The mean perceived pain score was 5. 13 with a range of 2 to 10. 2. The mean perceived family support score was 41.08$\pm$5.34 with a range of 20 to 50. 3. The mean perceived quality of life score was 134.07$\pm$19.82 with a range of 83 to 176. 4. Significant statistical difference was found between family support and quality of life (r=.331, p<0.001). A significant negative statistical difference was found between the family support and quality of life and pain(r=-.250, p<0.05, r=-.460, p<0.001). 5. General characteristics related to pain were exercise (t=4.72, p<0.0006). 6. General characteristics related to family support were age(F=2.65, p<0.0246), educational level (F=2.84, p<0.0282) and exercise (t=3.24, p<0.0452). 7. General characteristics related to quality of life were educational level (F=3.03, p<0.0392) and exercise (t=3.12, p<0.0465). It was found that the higher the level perceived pain, the lower the degree of perceived family support and the quality of life. It was also found that the higher the degree of perceived family support, the higher the degree of perceived quality of life. Accordingly, the conclusions from this study are that reduction of pain is achieved through the family support. Therefore, it is proposed that family support is an appropriate nursing intervention to improve the quality of life of patients with ankylosing spondylitis.

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Pathophysiology and MRI Findings of Infectious Spondylitis and the Differential Diagnosis (감염성 척추염과 감별질환의 병태생리와 MRI 소견)

  • Sunjin Ryu;Yeo Ju Kim;Seunghun Lee;Jeongah Ryu;Sunghoon Park;Jung Ui Hong
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1413-1440
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    • 2021
  • On MRI, abnormal signals of the intervertebral disc, destruction of the upper and lower vertebral body endplate around the disc, and bone marrow edema around the endplate are considered typical findings of infectious spondylitis. These findings can also appear in various non-infectious spinal diseases, such as degenerative changes, acute Schmorl's node, spondyloarthropathy, synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO), chronic recurrent multifocal osteomyelitis, and calcium pyrophosphate dihydrate crystal deposition disease. The imaging findings of infectious spondylitis that can be differentiated from these non-infectious spinal diseases on MRI are high signal intensity and abscess of the disc space, an abscess in the paraspinal soft tissue, and the loss of the linear low signal intensity on T1-weighted images of the bony endplate. However, these differentiation points do not always apply since there are many similarities in the imaging findings of infectious and non-infectious diseases. Therefore, for an accurate diagnosis, it is important to know the imaging characteristics related to the pathophysiology of not only infectious spondylitis but also non-infectious spinal diseases, which requires differentiation from infection.

Early Detection of Sacroilitis by 3-Dimensional Analysis (3차원적 구조분석을 통한 천장관절염의 조기진단)

  • Jun, Jae-Han;Kim, Sun-Il;Lee, Doo-Soo
    • Proceedings of the KOSOMBE Conference
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    • v.1992 no.11
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    • pp.100-102
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    • 1992
  • Currently, detection of sacroilitis is necessary in detect ion of ankylosing spondylitis. So early detection of sacroilitis is needed for early detection of ankylosing spondylitis. But it is difficult to detect sacroiliac abnormalities in early stage by conventional plain X-ray. Therefore, it is performed 3-dimensional volume rendering from the CT image of sacroiliac. Then early detection of sacroilitis is made by analyzing the reconstructed 3-dimensional image.

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Three Cases of Unusual patterns of Pyogenic Spondylitis (척추의 비전형적 감염 3례)

  • Ahn, Myun-Whan;Suh, Dae-Jin;Ahn, Jong-Chul;Ihn, Joo-Chul
    • Journal of Yeungnam Medical Science
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    • v.7 no.2
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    • pp.189-195
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    • 1990
  • Pyogenic vertebral osteomyelitis is rare. It most commonly occurs at the lumbar area and in the fifth to seventh decades of life. Most individuals present with back pain, abdominal pain, hip pain and meningeal syndrome. We experienced three cases of unusual patterns of pyogenic osteomyelitis. The first case developed after sepsis. The second case developed after open fracture and infection of other site. The third case was misdiagnosed as metastatic cancer. We present these cases with a brief review of literatures.

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Interleukin-32 Gamma as a New Face in Inflammatory Bone Diseases

  • Lee, Eun-Jin;Choi, Bongkun;Hwang, Eui-Seung;Chang, Eun-Ju
    • Journal of Rheumatic Diseases
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    • v.24 no.1
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    • pp.14-20
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    • 2017
  • Interleukin-32 (IL-32), a recently identified pro-inflammatory cytokine, is involved in the pathogenesis and progression of infections, cancer, chronic inflammation, and autoimmune disease. IL-32γ is the most active isoform in cell death and cell activation among nine distinct isoforms of IL-32. IL-32γ potentiates both osteogenic and osteoclastogenic capacities, and is critical in the coupling of bone resorption and bone formation for maintenance of bone homeostasis. IL-32γ is strongly associated with inflammatory bone disorders such as rheumatoid arthritis, ankylosing spondylitis, and osteoporosis. In this review, we summarize current research on the role of IL-32γ in inflammatory bone disorders, highlighting this cytokine as a novel target for prognostic marker and control of these diseases.