Scintigraphic evaluation andprognosis ofpatients withReiter's syndrome

Knowledge oftheassociation ofReiter's syndrome (RS)withthegenetic marker HLA-B27hasnotonly given us a useful diagnostic toolbuthasalso heightened our awarenessoftheassociation ofthis disease withankylosing spondylitis (AS).This association hasbeenrecognised clinically forvery many years.134 A numberofauthors thought that under these circumstances AScould beregarded asa complication ofRS.Theproportion ofsuchpatients recognised depends ontheduration offollow-up but could wellbeoftheorder of25%.0/0 Thisfigure is verysimilar tothereported prevalence ofsacroiliitis seenon screening B27-positive blooddonors.54 It could therefore beargued that theassociation ofAS withRSisno more thanpurely coincidental, since both arelargely dependent onthepresenceofHLAB27.Itisourown prejudice thatthis isnotso,and there issomeclinical evidence tosupport this view. We havelooked atthesacroiliac scintiscans in patients withRStoseeifwe canshowthat sacroiliac changes area common ifnotintegral partofthis disease.