Ankylosing spondylitis in a military aviator

Abstract

Ankylosing spondylitis or Marie Strümpell disease, the most common form of the spondyloarthritides, is a chronic inflammatory disease principally involves the hips and axial skeleton and peripheral joints. In addition, in severe forms of disease, systemic involvements such as uveitis, pulmonary fibrosis and aortic insufficiency can be seen. Its onset is insidious, can have extra-articular manifestations, and is diagnosed by clinical suspicion supported by imaging techniques and associated human leukocyte antigen HLA-B27. The disease may present with nonspecific symptoms such as low fever, fatigue and weight loss. The illness commonly affects young adults with a peak of the third decade of life. The male to female ratio is approximately 2 to 3:1. In the aviators, medical problems may induce a large impact on the ability of aircrew,s safety and their duties. Musculoskeletal diseases that affect the joints and range of motion are important when conside aviators as waiver for aircrew members. Non-specific symptoms such as fatigue may decrease tolerance to acceleration forces in military aviators. So flight surgeons must consider severity of disease and adverse reaction of drugs on the flight safety and its impact on health,s aviator. In this paper we report a jet pilot with ankylosing spondylitis disease with a good response to treatment with etanercept.