The plain films show a “bamboo spine,” which is characteristic of ankylosying spondylitis. The typical presentation for this condition is a young man complaining of a stiff back. When advanced, the disease can result in fusion of the sacroiliac joint which can severely limit mobility. Ankylosing spondylitis is an inflammatory disease associated with a positive HLA-B27 antigen along with psoriasis, inflammatory bowel disease, and Reiter’s syndrome (mnemonic: PAIR).
While the PAIR mnemonic is handy, it's worth remembering that Reiter's is an outmoded term for reactive arthritis. Reiter wasn't the first to describe the syndrome attributed to him. More importantly, he was a member of the Nazi party and experimented on prisoners at Buchenwald, for which he was prosecuted at Nuremberg. He, along with Wegener (to whom the condition granulomatosis with polyangiitis (GPA) has been attributed) do not deserve continued recognition from the medical community, and patients do not deserve to carry diagnoses with these names. Please consider this entreaty to use the more precise, descriptive titles for these conditions and remember the horrors these Nazi doctors committed, but not their names.
The plain films show a “bamboo spine,” which is characteristic of ankylosying spondylitis. The typical presentation for this condition is a young man complaining of a stiff back. When advanced, the disease can result in fusion of the sacroiliac joint which can severely limit mobility. Ankylosing spondylitis is an inflammatory disease associated with a positive HLA-B27 antigen along with psoriasis, inflammatory bowel disease, and Reiter’s syndrome (mnemonic: PAIR).
ReplyDeleteExcellent case.
ReplyDeleteWhile the PAIR mnemonic is handy, it's worth remembering that Reiter's is an outmoded term for reactive arthritis. Reiter wasn't the first to describe the syndrome attributed to him. More importantly, he was a member of the Nazi party and experimented on prisoners at Buchenwald, for which he was prosecuted at Nuremberg. He, along with Wegener (to whom the condition granulomatosis with polyangiitis (GPA) has been attributed) do not deserve continued recognition from the medical community, and patients do not deserve to carry diagnoses with these names. Please consider this entreaty to use the more precise, descriptive titles for these conditions and remember the horrors these Nazi doctors committed, but not their names.
David, thank you for your comment! We absolutely agree and appreciate your comment.
ReplyDeleteFor everyone else, please note that the R in "PAIR" should be remembered as Reactive Arthritis.