Brief in English from Bechterew-Brief No. 85

The article on a biomechanical analysis of posture in patients with spinal kyphosis due to ankylosing spondylitis by S. D. M. BOT et al. in Amsterdam has been translated from Rheumatology 1999. In their pilot study, the authors conclude that the hip joint extension is essential for balance control and also for the field of vision, and that conservative therapy of AS should thus focus on the pre-vention of the hip joint mobility restrictions.

A. STADIE in his article on the role of HLA-B27 in the diagnosis of ankylosing spondylitis, points out that B27 positivity alone does not mean a high probability for AS. Only in combination with other criteria, it may be used to support the diagnosis. The paper is supplemented by a curve published by M. A. KHAN and his brother M. K. KHAN (a mathematician) in 1982, showing the post-test probability of AS in dependence of the pre-test probability.

Among the pharaos of the 18th and 19th dynasty of Old Egypt, at least three had ankylosing spondylitis: Amenhotep II, Ramses II („The Great“), and his son Merenptah. An illustrated review is given on the life especially of Ramses II, on the wild history of the tombs of these pharaohs, of the detection of their mummies in the 19th century and on the main results of their paleopathologic investigation in 1967 and 1976.

The medical network “Inflammatory rheumatic diseases” has been created in 2000, supported by Germany’s Federal Ministry of Education and Science, to link patient care, education and research. Research on spondyloarthropathies is one of the three research fields included. The second symposium of the researchers involved took place in Bamberg in March 2001. For a research project on early Spondyloarthritis, patients with a disease duration of less than 10 years are required.

I have summarised 49 articles on ankylosing spondylitis that have appeared in scientific journals during the year 2000. The articles mentioned concern the origin and course of the disease, its diagnosis, its therapy, associated symptoms, other spondyloarthropathies, their inheritance and the influence on lifestyles.

E. SENN, until recently head of a hospital in Bellikon, Switzerland, is now practising in Lucerne. He gives a review of the role of different methods of electrotherapy for the treatment of symptoms associated with ankylosing spondylitis. He also gives some general recommendations concerning the treatment of AS. Our cartoonist C. Born has contributed a cartoon showing a patient using his own type of electrotherapy.

C. AUCKENTHALER (former president of the Swiss AS society, SVMB), S. BACHMANN, and G. STUCKI (now at the University of Munich) performed a randomised double-blind study of the effectiveness of vitamin E compared to diclofenac in the treatment of 174 patients with ankylosing spondylitis. They found that vitamin E reduces pain less effectively than diclofenac but significantly more effectively than placebo and thus constitutes a helpful and side-effect-free means to control pain in patients with low pain score (0–2 on a 0–10 visual analogue scale). The article originally appeared in the SVMB newsletter.

M. Asim KHAN’s life experience as an AS patient and AS researcher, originally appeared in Annals of Internal Medicine under the title “On being a patient”. Having started his medical career as a surgeon, he had to undergo surgery himself several times, not only due to a spinal fracture but also due to heart and renal diseases. He describes a number of severe professional errors which have occurred in some of those surgeries and advocates a more open dialogue between physicians and their patients to prevent such mistakes.

Gastein’s Heilstollen answers a letter to the editors by explaining the security aspects in this radon treatment gallery.

DVMB News:
DVMB invites tenders for its research prize for the year 2002. The prize (combined with 4000 Euro donated by a pharmaceutical company) is offered for the best scientific work in the field of ankylosing spondylitis written in the German language. Papers have to be submitted by 1 February 2002. They may be unpublished or published after 29 May 2000 (the deadline of our 2000 research prize). Details are published in this issue as well as in scientific medical journals.

E. Feldtkeller