Spondylitis, Rheumatoid

(also Bekhterev’s disease, Ma-rie-Strümpell disease), a chronic systemic disease of the vertebral joints in man that often results in the rigidity (ossification) of the entire spine. The different forms of rheumatoid spondylitis were first described by the German doctor of internal medicine A. Strümpell (1886), by V. M. Bekhterev (1893), and by the French neuropathologist P. Marie (1898).

The etiology of rheumatoid spondylitis is unknown, although many investigators believe the disease to be an allergic reaction to the focus of an infection in the body. Rheumatoid spondylitis generally affects men between the ages of 20 and 40. It begins with inflammatory changes in the spinal joints and surrounding ligaments and muscles and develops for many years with intermittent exacerbations and remissions. The main symptoms are pain, increasing spinal stiffness, and changes in the spine’s shape, with a forward flexure characteristic of the thoracic and cervical spinal segments. Changes in the coxofemoral and other joints may also occur.

Roentgenologic examination of the spine is important in diagnosing rheumatoid spondylitis. Treatment consists in eliminating the focus of the infection, for example, by cleaning the oral cavity and removing chronically infected tonsils. Also used are corticosteroids, antibiotics, and anti-inflammatories, including butadion, Rheopyrine, and salicylates. Physical therapy and sanatorium-health resort treatment are important in treating the disease. Deformities may be prevented by traction and corrective exercise, as well as by sleeping on a hard, flat bed. Surgical treatment is used to correct spinal deformities and restore mobility in other joints.