Enteropathic Spondyloarthritis
Nekula J.1, Horák P.2, Ehrmann J.3
Radiologická klinika FN, Olomouc1 přednosta prof. MUDr. J. Nekula, CSc.III. interní klinika FN, Olomouc2 přednosta prof. MUDr. V. Ščudla, CSc. II. interní klinika FN, Olomouc3 přednosta prof. MUDr. J. Ehrmann, CSc. |
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Summary:
Whipple’s disease are called enteropathic and belong to a large group of serum-negative SpA. The
changes on the spine are similar to those occurring in ankylosing spondylitis; inthe peripheral joints
the predilection localization involves the large joints (hip, shoulders, knees). The authors demonstrate
two cases with advanced clinical and X-ray picture. The examination of a 70-year man with
ulcerous colitis displayed a picture of extensive disco-vertebral destruction on thoracic and lumbar
spine with non-homogenous structure of vertebrae and MR analysis showed a pathological mass in
epidural localization, which was the cause of paraparesis. The histological examination revealed
a non-specific, granulomatous inflammatory tissue. The operation uncovered an extensive instability
in all segments of thoracic and lumbar spine. In the second, 40-year patient with Crohn’s disease,
an extensive defect of the hip joints was found, which already required a total endoprothesis on both
sides at the age of 35 years. The X-ray picture of Bechterev’s disease on cervical spine revealed an
advanced stage, whereas the thoracic-lumbar spine was affected by solitary syndesmophytes.
The discussioncompares themost recent clinical and radiologicalknowledge published in the Czech
and foreign literature. It is possible that a considerable part of cases of s.c. non-differentiated
spondyloarthritis is accompanied by a latent form of Crohn’s disease. A very close relation of
intestinal inflammations to diseases of the joints and spine has become obvious fromimmunological
and other laboratory examinations.
Key words:
enteropathic spondyloarthritis – Crohn’s disease – ulcerous colitis
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