Clinical And Imaging Features Of Rheumatoid Arthritis With Ankylosing Spondylitis

ObjectivesTo examine the clinical and imaging features of the rheumatoid arthritis（RA）combined with ankylosing spondylitis（AS）,and to provide useful information for the early diagnosis and treatment.MethodsThe clinical data of 22 inpatients with RA complicated by AS in Department of Rheumatology,the Affiliated Hospital of Qingdao University from 2010 to 2016 were reviewed.The data of these patients were then compared with the clinincal data of 25randomly selected RA patients and 25 AS patients,who were also treated in the same department within the same period.Data of all patients were reviewed six months late again.Statistical analysis was performed with analysis of variance,independent-samples T test,Chi-square test.Results1.The cases of RA with AS accounted for 1.76%of inpatient RA patients,3.74%of inpatient AS patients,and 1.20%of total RA and AS patients.2.The disease was more common among middle-aged women.The common clinical manifestations were systemic symmetry peripheral and axial arthritis.Compared with the RA(43.06±33.40mm/1h;34.22±27.21?/mg·L^-1)and AS(18.83±17.53mm/1h;13.26±13.10?/mg·L^-1)groups,the RA with AS group(81.25±97.20mm/1h;67.78±65.74?/mg·L^-1)had significantly higher erythrocyte sedimentation rate and C-reactive protein level（F=6.826、10.756,P<0.01）.In the RA with AS group,there were no statistically significant deference between the level of rheumatoid factor and anti-CCP antibody compared to those in the RA group（P>0.05）.The positive rate of HLA-B27 in the RA with AS group was lower than that in AS group[57%（12/21）versus 84%（21/25）,χ²=4.060,P<0.05].The positive rate of ANA in the RA with AS and RA groups were higher than that in AS group[41%（9/22）、56%（14/25）versus 17%（4/24）,χ²=10.017,P<0.05].3.The RA with AS group and the RA groups were compared with the X-ray staging performance of both hands and wrists,the RA with AS group and the AS groups were compared with the X-ray or CT grading performance of the sacroiliac joint,There were no statistically significant deference between them,But the imaging features of RA with AS group were similar to the pathological changes typical found in RA and AS.4.RA with AS group was not responsive well to biotherapy compared to AS group,but better than RA group.ConclusionsRA with AS is not a rare clinical disease.This disease has high inflammatory activity,and its imaging features are similar to those of RA and AS combined.Since clinicians often fail to identify the disease,early diagnosis of the disease must be improved.