Thoracic Manifestations of Ankylosing Spondylitis

The most common thoracic manifestation of ankylosing spondylitis is ankylosis of the costovertebral joints limiting chest expansion. The lungs and pleura may also be involved in up to 30% of patients with ankylosing spondylitis.

Pleuropulmonary manifestations include:

• Upper lobe fibrosis: Cicatrization, cavitation, architectural distortion, and traction bronchiectasis.
• Nonapical interstitial lung disease: Follows the usual interstitial pneumonitis pattern: subpleural band opacities, thickened interlobular septae, parenchymal bands, ground-glass opacification, honeycombing.
• Bronchiectasis:
• Paraseptal emphysema:
• Tracheal abnormalities: Tracheobronchomegaly (Mounier-Kuhn syndrome, Rare)
• Mycetoma formation:
• Pleural thickening:
• Pleural effusion:
• Empyema:
• Pneumothorax:
• Cor pulmonale:
• Ankylosis of the costovertebral joints: Limits lung expansion

References

Fenlon HM, Casserly I, Sant SM, Breatnach E. Plain radiographs and thoracic high-resolution CT in patients with ankylosing spondylitis. AJR Am J Roentgenol. 1997 Apr;168(4):1067-72.