Early Pulmonary Involvement in Ankylosing Spondylitis: Assessment With Thin-section CT

• Published in: Clinical radiology Vol. 55; no. 8; pp. 632 - 636
• Main Authors: TURETSCHEK, KARL, EBNER, WOLFGANG, FLEISCHMANN, DOMINIK, WUNDERBALDINGER, PATRICK, ERLACHER, LUDWIG, ZONTSICH, THOMAS, BANKIER, ALEXANDER A.
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 01-08-2000; Elsevier
• Subjects: Adult; Aged; ankylosing spondylitis, high resolution CT, lung disease; Biological and medical sciences; Diseases of the osteoarticular system; Female; Humans; Inflammatory joint diseases; Lung Diseases - diagnostic imaging; Lung Diseases - etiology; Male; Medical sciences; Middle Aged; Respiratory Function Tests; Severity of Illness Index; Spondylitis, Ankylosing - complications; Spondylitis, Ankylosing - diagnostic imaging; Tomography, X-Ray Computed - methods; ankylosing spondylitis, high resolution CT, lung disease; Human; Lung disease; Statistical analysis; Radiodiagnosis; Respiratory disease; Diseases of the osteoarticular system; Inflammatory joint disease; Spondylarthropathy; Chronic; Distribution; Medical imagery; Complication; Computerized axial tomography; Diagnosis; Ankylosing spondylitis
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1053/crad.2000.0498

AIM: To determine the frequency and the distribution of early pulmonary lesions in patients with ankylosing spondylitis (AS) and a normal chest X-ray on thin-section CT and to correlate the CT findings with the results of pulmonary function tests and clinical data.
MATERIALS AND METHODS: Twenty-five patients with clinically proven AS and no history of smoking underwent clinical examinations, pulmonary function tests (PFT), chest radiography, and thin-section CT. Four of 25 patients (16%), who had obvious signs on plain films suggestive of pre-existing disorders unrelated to AS were excluded.
RESULTS: Fifteen of 21 patients (71%) had abnormalities on thin-section CT. The most frequent abnormalities were thickening of the interlobular septa in seven of 21 patients (33%), mild bronchial wall thickening in (6/21, 29%), pleural thickening and pleuropulmonary irregularities (both 29%) and linear septal thickening (6/21, 29%). In six patients there were no signs of pleuropulmonary involvement. Eight of 15 patients (53%) with abnormal and four of six patients (67%) with normal CT findings revealed mild restrictive lung function impairment.
CONCLUSION: Patients with AS but a normal chest radiograph frequently have abnormalities on thin-section CT. As these abnormalities are usually subtle and their extent does not correlate with functional and clinical data, the overall routine impact of thin-section CT in the diagnosis of AS is limited. Turetschek, K , (2000) Clinical Radiology53, 632–636.