Radiological changes in the cervical spine in ankylosing spondylitis.

Ankylosing spondylitis is not limited to the sacro-iliac joints and the lumbar and dorsal spine, but may also affect the cervical spine. Forestier, Jacqueline, and Rotes-Querol (1951) considered that the intervertebral joints were first affected, osteo-porosis being followed by narrowing and ankylosis, and later by the formation of syndesmophytes on the vertebral bodies. Romanus and Yden (1955) said that the first lesions were small erosions at the anterior corners of the vertebral bodies. Martel, Holt, and Robinson (1962) observed a resorption of bone on the anterior surface of the cervical spine in late cases. Atlanto-axial sub-luxations, which may occur in rheumatoid arthritis, Present Investigations We have examined a series of lateral films of the cervical spine in patients with ankylosing spondylitis (AS), rheumatoid arthritis (RA), and generalized osteo-arthrosis (GOA) to see whether any particular lesions are specific for ankylosing spondylitis in this region. Films were taken of the pelvis and of the lumbar and cervical spine. The criteria used for the diagnosis were those formulated at the symposium on population studies in Rome (Kell-gren, 1963). All showed bilateral sacro-iliitis. Patients with psoriasis (Sharp, 1957) or Still's disease (Carter, 1962, 1963) were excluded. There were 58 males and fifteen females. The average age of the males was 44 $Temporary member of the Department ofRheumatology.