Ankylosing Spondylitis in Women

In the 12 years since the Rheumatism Clinic was started at Westminster Hospital a special interest has been taken in ankylosing spondylitis, and although male patients have predominated it has become evident that this is an important cause of skeletal pain and disability in women also. Few series describing the condition as it affects women have been published. Tyson, Thompson, and Ragan (1953) reviewed sixty cases observed during the previous 20 years at the combined arthritis clinics of the Presbyterian and New York Hospitals; they noted a rather more frequent involvement of the cervical spine and symphysis pubis in women, and they thought that the course of the arthritis was more benign, but they concluded that on the whole there was little difference in the clinical picture between the sexes. Forestier, Jacqueline, and Rotes-Querol (1956) referred to fifty female patients; they also observed that spinal deformity was less frequently seen and was less severe than in men, but they did not consider that there were enough differences to justify the description of a female form of the disease. The present report is an analysis of the thirty female patients who have attended the clinic in the past 12 years in whom ankylosing spondylitis has been diagnosed. Several of them have been observed over several years; a full clinical examination has always included a note on the spondylometer reading, and on the chest expansion, as this is reduced at an early stage in the disease (Hart and Maclagan, 1955). Radiographs of the sacro-iliac joints were taken in all cases, and other parts of the skeleton were x-rayed when there were clinical indications.