Literature analysis of misdiagnosis of ankylosing spondylitis
Objective To analyze the literature and differential diagnosis of cases misdiagnosed as ankylosing spondylitis(AS).Methods With"AS"and"misdiagnosis"as keywords,Wanfang database,CNKI database and Chinese Medical Journal full-text database were used to search the literature reports of other diseases misdiagnosed as AS,and the basic information,symptoms,in-flammatory indicators,human leukocyte antigen B27(HLA-B27),imaging data and diagnosis of diseases were summarized and ana-lyzed.Results A total of 63 literature reports on other diseases misdiagnosed AS were retrieved,including 193 cases misdiagnosed as AS,aged 11 to 78 years,with an average age of(36.14±16.72)years.The main clinical manifestations were low back pain in 84 ca-ses(43.52%),morning stiffness in 71 cases(36.79%),lumbosacral pain in 48 cases(24.87%),fever in 38 cases(19.69%),and knee joint pain in 37 cases(19.17%).Erythrocyte sedimentation rate increased in 74 cases(38.34%),CRP increased in 65 ca-ses(33.68%).There were 43 HLA-B27 positive cases(22.28%)and 123 negative cases(63.73%).There were 20 normal cases(10.36%)and 158 abnormal cases(81.87%).There were 46 cases(23.83%)with bamboo like changes in the spine.The main misdiagnosed diseases were were sacroiliac joint infection in 57 cases(29.53%),brucellosis in 22 cases(11.40%),bacterial infec-tion in 20 cases(10.36%),tuberculosis in 15 cases(7.77%),skeletal fluorosis in 42 cases(21.76%),and hematological diseases in 15 cases(7.77%).Conclusions The clinical symptoms of AS are similar to those of many diseases,so attention should be paid to differentiation to prevent misdiagnosis.
ankylosing spondylitismisdiagnoseinfectionbone fluorosisdisease of blood system