Procto-colitis and other pelvic infections in relation to ankylosing spondylitis

Summary

• 1.

  Seven new cases of ankylosing spondylitis occurring in patients with ulcerative procto-colitis are reported.

• 2.

  The significance of pelvic (genito-urinary and alimentary) sepsis as an aetiological factor of sacroiliac arthritis and of ankylosing spondylitis is discussed.

• 3.

  Acute or chronic pelvic visceral sepsis may be responsible for destructive lesions of the sacro-iliac joints and elsewhere in the bony pelvis. These lesions may be frankly suppurative, or there may be no pus formation.

• 4.

  It is suggested that, in some patients, constitutionally and genetically determined, non-suppurative sacro-iliac arthritis, provoked by pelvic sepsis, may herald the development of classical ankylosing spondylitis.

• 5.

  It is concluded that chronic pelvic sepsis may be a major exciting or provocative factor in the development of ankylosing spondylitis.

• 6.

  A note is added describing the vertebral venous system; its possible pathological significance is discussed. This system may be involved in the pathogenesis of ankylosing spondylitis.