Ankylosing spondylitis historical perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


Ankylosing spondylitis was first recognized as a disease by Galen. However, in the late nineteenth century, three physicians (Vladimir Bekhterev, Adolph Strümpell, and Pierre Marie) were the first people to give adequate descriptions of the disease. Their work allowed for an adequate description of AS before it turned into a severe spinal deformity. For this reason, AS is also known as Bechterew Disease or Marie–Strümpel Disease.

Historical Perspective

Leonard Trask, the Wonderful Invalid.

AS was probably first recognized as a disease which was different from Rheumatoid arthritis by Galen as early as the second century AD[1]; however, skeletal evidence of the disease (ossification of joints and entheses primarily of the axial skeleton, known as "bamboo spine") were first discovered in an archaeological dig that unearthed the skeletal remains of a 5000 year–old Egyptian mummy with evidence of "bamboo spine".[2]

The anatomist and surgeon Realdo Colombo described what could have been the disease in 1559,[3] and the first account of pathologic changes to the skeleton possibly associated with AS was published in 1691 by Bernard Connor.[4] In 1818, Benjamin Collins Brodie became the first physician to document that iritis accompanied what is believed to have been a patient with active AS.[5]

In 1858, David Tucker published a small booklet which clearly described a patient by the name of Leonard Trask who suffered from severe spinal deformity subsequent to AS.[6][7]

In 1833 Trask fell from a horse, exacerbating the condition and resulting in severe deformity. Tucker reported that

It was not until he [Trask] had exercised for some time that he could perform any labor [..., and that] his neck and back have continued to curve drawing his head downward on his breast.
evidence of inflammatory disease characteristics of AS, and the hallmark of deforming injury in AS. This account became the first documented case of AS in the United States.

It was not until the late nineteenth century (1893-1898), however, when the neurophysiologist Vladimir Bekhterev of Russia in 1893,[8] Adolph Strümpell of Germany in 1897,[9] and Pierre Marie of France in 1898,[10] were the first to give adequate descriptions which permitted an accurate diagnosis of AS prior to severe spinal deformity. For this reason, AS is also known as Bechterew Disease or Marie–Strümpel Disease.


  1. Dieppe P (1988). "Did Galen describe rheumatoid arthritis?". Annals of the Rheumatic Diseases. 47: 84–87. 
  2. Calin A. (1985). "Ankylosing spondilitis.". Clinics in Rheumatic Diseases. 11: 41–60. 
  3. Pierre Marie (1995). "Benoist M. - Historical Perspective". Spine. 20: 849–852. 
  4. Blumberg BS (1958). "?". Arch Rheum. 1: 553. 
  5. Leden I (1994). "Did Bechterew describe the disease which is named after him? A question raised due to the centennial of his primary report.". Scand J Rheumatol. 23 (1): 42–5. PMID 8108667. 
  6. "Life and sufferings of Leonard Trask" (PDF for registered members)). Ankylosing Spondylitis Information Matrix. 
  7. "Life and sufferings of Leonard Trask". 
  8. Bechterew W. (1893). "Steifigkeit der Wirbelsaule und ihre Verkrummung als besondere Erkrankungsform.". Neurol Centralbl. 12: 426–434. 
  9. Strumpell A. (1897). "Bemerkung uber die chronische ankylosirende Entzundung der Wirbelsaule und der Huftgelenke.". Dtsch Z Nervenheilkd. 11: 338–342. 
  10. Marie P. (1898). "Sur la spondylose rhizomelique.". Rev Med. 18: 285–315.