Coexistence of Ankylosing Spondylosis with Benign Joint Hypermobility Syndrome. Are they Complementary to Each Other?

Abstract

Objective: To present cases of co-existence of pathologically opposite conditions ankylosing spondylitis (AS) and benign joint hypermobility syndrome (BJHS).Design: Clinical findings of 25 cases of ankylosing spondylitis with overlapping clinical picture of benignjoint hypermobility syndrome were evaluated.Results: There were 23 males and 2 females with the mean age of 25.92 + 7.54 years (age range 17-41years). The mean duration of the disease was 6.25 + 6.72 years. The mean Beighton’s score for jointhypermobility syndrome was 6.36 + 1.32. Schobers test was positive in 13 patients and 23 patients werepositive for HLA-B27. ESR was elevated in 24 patients and 68% patients were with grade II sacroilitis.Cardiovascular, ophthalmologic complications were also observed in some patients. Ligament and menisciinjuries were observed in 3 patients. It was observed that many of the patients had contracures of majorjoints along with spinal deformity and simultaneously they had hypermobility in other major and smaller joints.Conclusion: Coexistence of these two opposite disorders causes confusion and thus delay in the diagnosis and management, leading to further disability. Hypermobility can be advantageous for a stiff spine and for major joints. By the care of the joints and spine with proper exercises programme further deformities and soft tissue injuries can be prevented.

Keywords

• Ankylosing Spondylitis
• Benign joint Hypermobility Syndrome
• Exercise
• Rehabilitation