Treatment of ankylosing spondylitis with infliximab

In January 2000 a 35 year old man presented with severe ankylosing spondylitis (AS), diagnosed in 1981. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was 6.0, the Bath Ankylosing Spondylitis Functional Index (BASFI) was 3.0, and on a 1–10 visual analogue scale (VAS) for pain in the previous two months he had a score of 6. Schober's test was 0 cm (normal 4 cm), Ott's test 1 cm (normal 2 cm), finger-floor distance 16 cm, lateral flexion 3 cm, tragus-wall distance 21 cm, cervical rotation 30°. C reactive protein (CRP) was 41 mg/l (normal <5), erythrocyte sedimentation rate (ESR) was 25 mm/1st h (normal <15), and HLA-B27 genotype was positive. Conventional radiography showed typical signs of AS. Magnetic resonance imaging (MRI) detected inflammatory activity in …