Ankylosing Spondylitis a Review of 61 Cases

61 clinically diagnosed ankylosing spondylitis were further reviewed and studied according to the modified New york criteria for ankylosing spondylitis which is based on clinical and radiologic manifestions. This is a rather common chronic inflammatory disease of joints of the axial skeleton, particular the sacro-iliac joint and the spine. The bilateral sacroileitis with grade Ⅱ or more is diagnostic for ankylosing spondylitis but not pathognomonic since about 20% of other seronegative spondyloarthropathy such as inflammatory bowel disease e.g. ulcerative colitis, psoriatic arthropathy, Reiter's syndrome show similar changes; however these diseases can be differentialted from ankylosing spondylitis by their extra-skeletal manifestations. Our cases of ankylosing spondylitis satisfy both the Rome and New york criteria and show a male preponderance with male to female ratio of 9:1 (55 males and 6 females), 42 (69%) of the 61 are within the 20 to 40 years. The youngest patient is a 12 years old boy who exhibited appendicular joint complaints rather than the low back pain and with progressive sacro-iliac change and is HLA-B27 (+). This is the characteristic juvenile ankylosing spondylitis. Of the 21 cases with HLA-B27 tested, 11 (52%) were (+) and 10 (48%) were (-). All the B27 positive were male. This, and the striking male preponderance and young age of onset may suggest a sex-hormonal factor in disease expression.