Enthesopathy of rheumatoid and ankylosing spondylitis.

J Ball - Annals of the rheumatic diseases, 1971 - ncbi.nlm.nih.gov
J Ball
Annals of the rheumatic diseases, 1971ncbi.nlm.nih.gov
The invitation to speak before the Heberden Society on this annual occasion is a great
honour. For me it was also a stimulus to assemble some thoughts and observations on
spondylitis-a subject in which my colleagues and I have been interested for some time. It has
always seemed to me very odd that whilst rheumatoid arthritis (RA) and ankylosing
spondylitis (AS) can be distinguished on clinical, epidemiological, genetic, immunological,
and even therapeutic grounds, an acceptable pathological differentiation has yet to emerge …
The invitation to speak before the Heberden Society on this annual occasion is a great honour. For me it was also a stimulus to assemble some thoughts and observations on spondylitis-a subject in which my colleagues and I have been interested for some time.
It has always seemed to me very odd that whilst rheumatoid arthritis (RA) and ankylosing spondylitis (AS) can be distinguished on clinical, epidemiological, genetic, immunological, and even therapeutic grounds, an acceptable pathological differentiation has yet to emerge. Indeed, histological studies often emphasize the similarities rather than explain the differences. The synovial reaction appears to be the same in both (Julkunen, 1966); and Cruickshank (1951) has said that one can match all stages in diarthrodial joints in RA and AS, which is to an extent true but nevertheless does not help us to understand, for instance, the obvious difference in the behaviour of the diarthrodial sacroiliac joints. We have also been repeatedly told (Guntz, 1933; Freund, 1942; Geiler, 1969) that spinal apophyseal arthritis is common to both; but the mechanisms
ncbi.nlm.nih.gov