• Cornelson SM
• Beavers D
• Harvey A
• Hogarth W
• Kettner NW

• Adult
• Affiliation / Logan University. Chiropractic Health Centers
• Affiliation / Logan University. Department of Radiology
• Affiliation(G) / United States / Missouri / Chesterfield
• Female
• HLA-B Antigens / analysis
• Male
• Radiology
• Sacroiliac Joint / diagnostic imaging
• Spondylitis, Ankylosing / diagnosis

Objective: This report describes chiropractic management for 3 cases of inactive ankylosing spondylitis (AS).

Clinical Features: A 25-year-old woman presented with chronic, mechanical neck pain and stiffness that was ultimately diagnosed as AS. A 23-year-old man presented with chronic low back and left hip pain that was diagnosed as AS. A 31-year-old man with low back pain presented with a known diagnosis of AS. Physical examination in 2 cases failed to identify systemic findings associated with AS. In the third case, examination revealed a history of ulcerative colitis. Laboratory examination of case 2 yielded a positive HLA-B27, but cases 1 and 3 were HLA-B27 negative. The acute reactants were negative in all 3 patients, indicating an inactive phase of disease. All 3 patients underwent spinal imaging including sacroiliac joint radiography. In case 3, magnetic resonance imaging of the sacroiliac joints was performed. All 3 imaging examinations revealed bilateral, symmetric sacroiliitis.

Interventions and Outcome: Patients were managed by both a medical rheumatologist and a doctor of chiropractic. Chiropractic care ranged from instrument-assisted spinal manipulation to diversified spinal and soft tissue manipulation and Cox flexion-distraction. Patients were given home stretches and rehabilitation exercises. All 3 patients experienced some relief of their symptoms including pain reduction and improved activities of daily living.

Conclusion: These 3 patients displayed differences and commonalities in clinical, laboratory, and imaging features. Chiropractic manipulation and rehabilitation seemed to be beneficial in reducing symptomatology and improving musculoskeletal function for these 3 patients. These findings suggest the potential for collaborative or integrative management in similar cases.

Author keywords: Ankylosing Spondylitis; HLA-B27 Antigen; Radiology; Chiropractic; Spinal Manipulation

Author affiliations: Logan University. Radiology Department (United States / Missouri / Chesterfield); Logan University. Chiropractic Health Centers

This abstract is reproduced with the permission of the publisher; full text is available by subscription.