Synonym: Forestier Syndrome (for axial involvement)
Features:
(1) The condition is more common in the elderly with onset after 50 years of age.
(2) It is more common in the thoracic spine but can also involve the cervical and lumbar spine.
(3) Changes in axial sites include:
(3a) calcification and ossification of ligaments (posterior longitudinal ligament, anterior longitudinal ligemant, etc)
(3b) ossification along the anterolateral aspect of vertebral bodies with "flowing" osteophytes
(3c) joint ankylosis
(3d) vertebral fractures
(4) Changes in extra-axial sites tend to be symmetrical and include:
(4a) calcification of ligaments and tendons
(4b) para-articular osteophytes
(4c) bony excrescences where tendon or ligaments attach to bone (entheses)
Clinical findings include:
(1) stiffness and pain in the back that is worse after inactivity
(2) stiffness and pain in tendons
(3) myelopathy secondary to cord compression
(4) dysphagia due to compression of the esophagus by osteophytes
(5) foot pain
(6) pain in affected joints - knee, hip, elbow, other
Differential diagnosis:
(1) inflammatory spondyloarthropathies
