Abstract：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, inflammatory indicators, human leukocyte antigen B27 (HLA-B27), imaging data and diagnosis of diseases were summarized and analyzed. 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 cases (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 cases (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 infection 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.
Maksymowych W P, Lambert R G, Stergaard M,et al.MRI lesions in the sacroiliac joints of patients with spondyloarthritis: an update of definitions and validation by the ASAS MRI working group[J].Ann Rheum Dis,2019,78(11):1550-1558.
Maksymowych W P,Baraliakos X,Weber U,et al.Preliminary definition of a positive mri for active lesions in the sacroiliac joints typical of axial spondyloarthritis[J]. Ann Rheum Dis 2020,79 (Suppl 1):53-54.
[17]
Maksymowych W P, Lambert R G, Stergaard M,et al.MRI lesions in the sacroiliac joints of patients with spondyloarthritis: an update of definitions and validation by the ASAS MRI working group[J].Ann Rheum Dis,2019,78(11):1550-1558.
[18]
Maksymowych W P,Baraliakos X,Weber U,et al.Preliminary definition of a positive mri for active lesions in the sacroiliac joints typical of axial spondyloarthritis[J]. Ann Rheum Dis 2020,79 (Suppl 1):53-54.
2024, Vol. 35 
