Non-specific Spondylitis Research Articles

Nonspecific spondylitis of infants and children.

It is our purpose to present 6 cases of self-limited spondylitis of infants and children. All were characterized by failure to identify a specific infectious agent, a mild clinical course, positive roentgen findings, and recovery without antibiotics. The radiographic findings were indistinguishable from those of pyogenic osteomyelitis of the spine. In 1950 Saenger reported 4 cases of spondylarthritis in children, with systemic signs of infection but negative diagnostic tests for a specific infective agent (16). The radiographic changes, consisting in narrowing of an intervertebral disk space and mild destructive lesions in the contiguous surfaces of the involved vertebral bodies, were progressive for one to two months and then regressed over another two to eight months, with only partial restoration of a normal picture. Saenger pointed out that Smith had reported a group of similar cases in 1933 in adults. Reference was also made to a paper by Ghormley et al. in 1940 (7), in which an analogous syndrome was described under the title “Acute Infectious Lesions of the Intervertebral Disks,” but again most of the patients were adults. Dupont and Andersen (5), in 1956, reported 4 cases of what they called “nonspecific spondylitis in childhood,” with an age range from twenty-one months to nine years. The illness pursued a subacute course and manifested the same radiographic changes and time sequence as Saenger's cases. Dupont and Andersen also emphasized the four clinical syndromes which spondylitis may assume. The first and most usual is back pain with spinal muscle spasm; the second is the hip joint or hip-leg syndrome with limitation of weight-bearing due to pain in the hip or leg plus flexion contracture of the thigh; the third is the abdomen-chest syndrome; the fourth is the meningeal, with stiff neck and positive Kernig or Brudzinski tests. The cases of Dupont and Andersen also yielded no proof of a specific etiology. The 6 cases which we have encountered in the past five years will be briefly reviewed and compared with those reported by Saenger and Dupont and Andersen. The accompanying tables include a fourth series reported by Bremner and Neligan in the British Medical Journal under the title “Benign Form of Acute Osteitis of the Spine in Young Children” (1). Some of the features of the previously mentioned groups of cases are compared with our series, from the University of California at Los Angeles, in Table I. As seen here, the sex incidence was equal in all series. This is in contrast to pyogenic osteomyelitis of the spine which has a higher incidence in the male (21). The age spread was increased in the current series, with 2 infants of seven months. The initial symptom complex varied among the four major syndromes; only 3 of the 14 cases reported by Saenger, Dupont and Andersen, and the authors of this paper clearly presented with back pain. The hip-leg syndrome was the most common, occurring in 6 of the 14 patients.

Non-specific spondylitis in childhood.

SummaryThe authors report 4 cases of non‐specific spondylitis in children aged 1–10 years. These 4 patients presented 4 widely different syndromes: Meningeal, back‐pain, abdominal, and hip‐joint syndromes. The aetiology seems to have been staphylococcal infection in 2 cases.Spon, dylite non spkifique duns l'enfance.L'auteur rapport 4 cas de spondylite non spécifique chez des enfants âgés de 1 à 10 ans. Ces quatre malades présentaient 4 syndromes absolument différents: tableau de méningite, de douleur dorsale, de coxarthrie et syndrome abdominal. Dans deux cas, l'étiologie semblait imputable à une infection staphylococcique.Unapezif w h e 8pondylitis im Kindesalter.Die Autorin bertchtet uber 4 Fiille von unspezifischer Spondylitis bei Kindern irnAlter von 1–10 Jahren. Tliese 4 Patienten wiesen 4 verschiedene Syndrome auf:Meningialti Erscheinungm, Riickenschmerzen, abdominelle Beschwerden und Huft‐egelenkssyniptorne. Atiol,)psch kommt in 2 FIillen eine Staphylokokken‐Infektion in Frage. Espondilitin irtrspecificri (')I la injancia. El autor comunica 4 casos de espondilitis no especifica en niiios entre 1 y 10 aiios de edad. Presentaron 4 sindromes diferentes: Meningeo, dolor dorsal, abdominal y de la articulacibn de la cadera. En 2 casos, la etiologia parecib ser estafilocbccica.