• Title/Summary/Keyword: spondyloarthropathy

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Acute Low Back Pain from Coexisting Gout and Tuberculous Spondyloarthropathy (급성 요통을 일으킨 결핵과 통풍이 혼재된 척추관절병증)

  • Park, Yung;Ha, Joong Won;Kwon, Ji-Won;Eum, Kwangsik
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.4
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    • pp.351-356
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    • 2021
  • A 67-year-old male patient with a history of epididymectomy and anti-tuberculosis treatment for epididymis tuberculosis was admitted for acute low back pain and radiating pain. The patient had no history of gout but showed hyperuricemia and a bone destruction lesion in the facet joint and lamina of the lumbar spine. A histology examination was performed after a computed tomography-guided needle biopsy, and the findings were compatible with gout spondyloarthropathy and tuberculous spondylitis. The acute symptoms improved after conservative treatment for gouty arthritis. When patients with hyperuricemia risk factors, such as taking anti-tuberculosis drugs, complain of acute low back pain, gout spondyloarthropathy should be considered in a differential diagnosis.

Effectiveness of Exercise Therapy on Physical Function in Patients With Ankylosing Spondylitis: Systemic Review and Meta-Analysis (강직성 척추염 환자의 신체기능에 대한 운동치료의 효과: 체계적 고찰과 메타분석)

  • Shim, Jae-Hun
    • Physical Therapy Korea
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    • v.16 no.3
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    • pp.50-59
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    • 2009
  • The aim of the study was to evaluate the effectiveness of exercise therapy on physical function of patients with anklyosing spondylitis (AS) through the systemic review and meta-analysis. The 54 studies were identified from computerized search of published researches on PubMed, Embase, CINAHL, PEDro, KISS, KERIS database until February, 2008 and review of reference lists. The main search terms were the combination "ankylosing spondylitis", "exercise", "spondyloarthropathy and exercise", "ankylosing spondylitis and physical therapy". The subgroup analysis was performed by the publication year, quality score, type of disease, content of intervention, intervention provider, type of intervention, method of intervention, intervention period and the point of outcome measured. Two reviewers independently selected trials for inclusion, assessed the quality and extracted the data. The result was as follows: The 10 trials were eligible for inclusion criteria, then the systematic review and meta-analysis was assessed on effectiveness of exercise therapy. The meta-analysis of 10 studies based on the random effect model showed that the exercise therapy was beneficial in treating the diseases (effect size .55; 95% confidence interval -.3.75~.61). The findings suggest that the exercise therapy would be appropriate to manage the physical function of AS with evidence based on Meta-analysis. Therefore, the exercise therapy supervised by physical therapist should be recognized as the essential approach to manage the AS and necessarily recommended to improve physical function.

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The Thoracic Radiculopathy in SAPHO Syndrome - A Case Report - (SAPHO 증후근에서의 신경근병증 - 증 례 보 고 -)

  • Han, Seok;Cho, Tai Hyoung;Kim, Se Hoon;Lim, Dong Jun;Park, Jung Yul;Chung, Yong Gu;Suh, Jung Keun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.11
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    • pp.1320-1323
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    • 2001
  • SAPHO syndrome is an acronym for an increasingly recognized syndrome of synovitis, acne, pustulosis, hyperostosis, and osteitis. Most of the previously reported case are from Japan and Europe. The authors report a case of SAPHO syndrome in Korean female who presented with extrasternal neurologic symptoms. A 60-year-old female with thoracic and right chest wall pain presented with the sternocostoclavicular hyperostosis, and recurrent aseptic osteitis. Previously, she had hystrectomy and thyroidectomy due to uterine malignancy 25 years ago. Also, she started to take medications for palm and sole pustulosis 7 days prior to admission. Through evaluation of clinical, radiological, serological studies, studies was done along with bone needle biopsy for the biological reassessment. The hyperostosis was found in the pedicles of thoracic 8, 9, 10 vertebrae and sternoclavicular joint. Radio-isotope bone scan showed an accumulation of tracer in thoracic vertebra. The bone biopsy from these site showed increased osseous turnover, thickening of trabeculae accompanied by mild acculuation of granulation tissue and round cell infiltration, compatible with mild chronic inflammation with marrow fibrosis. The patient showed good response to conservative management. The authors report a case of SAPHO syndrome with thoracic radiculopathy. It is considered that SAPHO syndrome is related to spondyloarthropathy, and appears to have benign disease process with good prognosis.

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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.