Ankylosing hyperostosis. I. Clinical and radiological features.

Ankylosing hyperostosis is a condition in which new bone is laid down on the right antero-lateral aspect of the dorsal vertebrae and across the intervertebral spaces forming spurs or bridges. The lumbar and cervical spines, pelvis, hips, and knees may also be involved. There is no single approved name for this condition. Oppenheimer (1942) described 'Calcification and ossification of vertebral ligaments'. Forestier and Rotes-Querol (1950) named it 'senile ankylosing hyperostosis of the spine', but in later works (Forestier and Lagier, 1971) the adjective 'senile' was omitted when the condition was described in younger patients. Smith, Pugh, and Polley (1955) described 'physiologic vertebral ligamentous calcification' and Haijkova, Streda, and Skrha (1965) 'hyperostotic spondylosis'. Beardwell (1969) termed this condition 'ankylosing vertebral hyperostosis' and Julkunen, Heinonen, and Py6rala (1971) referred to 'hyperostosis of the spine'. Bywaters and Forestier (1967) presented a revised system for nomenclature of spinal diseases at the 6th European Congress of Rheumatology. They advised that this condition be named 'ankylosing hyperostosis', and this is the terminology which we have adopted. An association with diabetes mellitus has been shown by several authors, including Boulet and Mirouze, (1954), Hajkova' and others (1965), Bywaters, Doyle, and Oakley (1966), and Ott, Perkovac, and Regehr (1967). Julkunen and others (1971) found an association with diabetes and obesity. Boulet, Serre, and Mirouze (1954) suggested that this condition is due to an increased production of growth hormone occurring when the secretion of gonadal hormones declines, and in fact, Julkunen, Karava, and Viljanen (1966) found six cases of hyperostosis of the spine in 21 acromegalic patients. Beardwell (1969) showed a familial incidence and relationship with tylosis in a Greek Cypriot family. Ott (1953) and Smith and others (1955) considered the disease to be an exaggerated form of osteoarthrosis of the spine. Although many European authors have described the clinical, radiological, and pathological features of ankylosing hyperostosis, there has been no report of a series of patients with this condition from this country. This paper describes the clinical and radiological features of a series of patients seen at various hospitals in the East End of London. Particular reference has been made to the possible association with acromegaly.