POSTTRAUMATIC ANKYLOSING-SPONDYLITIS (2 NEW CASE-REPORTS)

Two highly unusual cases of typical ankylosing spondylitis ankylosing spondylitis in previously healthy, athletically active individuals, wi th onset immediately after a severe injury are reported. One of these patients had ankylosing spondylitis of 25 years duration which had bee n completely quiescent for the last five years ; he sustained a fractu re of the cervical spine which was immediately followed by a severe ex tensive flare of ankylosing spondylitis. Although the concept of postt raumatic ankylosing spondylitis has been challenged recently, these tw o cases, as well as previously published data, demonstrate that injuri es can precipitate ankylosing spondylitis. The injury is one of the ma ny factors (including genetic susceptibility) which lead to developmen t of clinical disease. Diagnostic criteria, which should be stringent, are reviewed. Pathogenetic hypotheses are discussed.