Small joint ankylosis in rheumatoid arthritis: a vanishing phenomenon or a pathogenetic clue, or both?
1 Section of Rheumatology, Department of Internal Medicine, Central Hospital, Kristianstad, Sweden
2 Section of Rheumatology, Department of Medicine, Helsingborg’s Lasarett, Helsingborg, Sweden
Correspondence to:
Dr I Leden, Bokvägen 27, 291 43 Kristianstad, Sweden; ido.leden@telia.com
Accepted 24 March 2008
| The first 150 words of the full text of this article appear below. |
The main pathological feature of rheumatoid arthritis (RA) is synovitis, which may become erosive and extend to cartilage and bone and cause bone resorption with subsequent joint instability. In contrast, the spondyloarthropathies are characterised by enthesitis, which may bring about new bone formation with osteophytes and ankylosis.
Only recently these important differences in pathogenesis have become elucidated.1 Earlier, ankylosis had been accepted as a part of RA.2 Interestingly, in palaeopathological publications the existence of ankylosis in RA has for a long time been a matter of dispute and even denied.3–5
To examine this subject further, the occurrence of spontaneous ankylosis was studied in patients attending the rheumatology unit at Kristianstad County Hospital in southern Sweden serving an area of about 170 000 inhabitants.
Two cohorts of patients were studied during a 4-year period (1998–2001). The first cohort comprised 325 consecutive patients from the outpatient clinic. These patients had longstanding RA
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