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. 2015;53(5):279-85.
doi: 10.5114/reum.2015.55832. Epub 2015 Dec 8.

Coexistence of rheumatoid arthritis and ankylosing spondylitis

Tacjana Anna Barczyńska  1 , Małgorzata Węgierska  1 , Paweł Żuchowski  2 , Marta Dura  3 , Joanna Zalewska  1 , Marzena Waszczak  4 , Sławomir Jeka  1
Affiliations

Coexistence of rheumatoid arthritis and ankylosing spondylitis

Tacjana Anna Barczyńska et al. Reumatologia. 2015.

Abstract

Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are chronic progressive inflammatory diseases, leading to joint damage and reducing the physical fitness of patients. They are among the most common rheumatic diseases. However, their etiology and symptomatology are different. Formerly, AS was often wrongly diagnosed as RA. Today there are no major diagnostic difficulties in differentiation between these diseases, thanks to modern laboratory tests and imaging. However, a problem may arise when the patient has symptoms typical for both diseases simultaneously. Cases of coexistence of RA with AS - according to our best knowledge - are rare. This study aims to compare our experience in diagnosis and treatment of concomitant RA and AS with the experience of other researchers. Implementation of the proper diagnostic algorithm, allowing for correct diagnosis of both diseases in one patient, may be useful for differential diagnosis of similar cases in the future.

Keywords: ankylosing spondylitis; rheumatoid arthritis; sacroiliitis.

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Figures

Fig. 1
Fig. 1
X-rays – case 1. Advanced inflammatory and destructive changes indicative of ankylosis in both wrists. Subluxation and inflammatory changes with erosions in the MCP joints (A). Subluxation and inflammatory changes with erosions in the MTP joints (B). Ankylosis of the sacroiliac joints (C). Cervical spinal fusions on the level of vertebral pedicles (D).
Fig. 2
Fig. 2
X-rays – case 2. Advanced inflammatory and destructive changes with erosions in the right wrist (A). Subluxation, inflammatory and destructive changes with erosions in the MTP joints (B). Ankylosis of the sacroiliac joints (C). A tendency to squaring of the vertebral bodies, ossification of the anterior longitudinal ligaments at C3-C4 and C5-C6-C7 (D).
Fig. 3
Fig. 3
X-rays – case 3. Degenerative lesions in the DIP joints (A). In the feet bones – osteoporosis and minor erosion at the base of the proximal phalanx of the finger and the left foot (B). Bilateral sacroiliitis grade III/II (C). A bony bridge on the right side edge of Th10 and Th11 vertebral bodies. A syndesmophyte on the left side edge of L3 vertebral body (D).
See this image and copyright information in PMC

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