RHEUMATOID SPONDYLITIS: MANIFESTATIONS AND MANAGEMENT

Abstract

The clinical manifestations, physical signs, laboratory data and radiographic changes noted in 267 male patients who had rheumatoid spondylitis are analyzed. In the majority, the onset of the disease was insidious and the initial manifestations varied considerably. When well-developed, the disease induced characteristic manifestations and was easily recognized. During the early stages, however, the diagnosis was often difficult. The authors found the following data of value: (1) History of aching and stiffness in any part of the lumbodorsal and lumbosacral spine; (2) The careful evaluation of leg and spinal maneuvers and flexibility of the spine on body movements; and (3) Meticulous examination of inclined radiographic views of the sacroiliac joints and oblique views of the lumbosacral spine. Treatment consisted of physiotherapeutic and dietetic measures, postural and breathing exercises, correction of static factors, and of established deformities by orthopedic procedures, fitting with appropriate braces, X-irradiation and the judicious use of aspirin, hydrocortisone and butazolidine. Good or excellent results were noted in 75% of the patients.