Ankolysisng spondylitis

Question 1

Define Ankolysisng spondylitis

Answer 1

Defining feature - inflammation of the place where tendons adhere to bone (Enthesis-fascia insertions)
considered AS when its on Xray
If on MRI-Axial Spondylarthritis

Question 2

Aetiology and risk factors of Ankolysisng spondylitis

Answer 2

HLAB27-like all seronegative spondylarthritis (reactive/psoriatic/entero)
At Enthesis-atypical T cells that produce IL23
progressive damage -can see it early on MRI but asympto
a lot of women stay around the axial part

present in male>female
Young (under 25)

Question 3

epidiemology of Ankolysisng spondylitis

Answer 3

present in male>female

Young (under 25)

Question 4

Signs and Sx of Ankolysisng spondylitis

Answer 4

Inflam like back pain
gradual onset
worse in morning
Stiff and painful in morn
worse in rest
Limited forward flexion
can present with asymetrical joint issues (like all seronegative arthritides)

Examine spine-
Chest expansion, rotation extension flexion-for all of them
Shcobers test - point 5cm above L5- has to move more than 5cm as patient bends forward

Question 5

Investigation of Ankolysisng spondylitis

Answer 5

xray of pelvis show sacro-illitis

MRI–Shiny corner-Enthititis-visible

later cray-calcification of joints, bridging bones between vertebrae–thats when its considered AS

Question 6

Management of Ankolysisng spondylitis

Answer 6

Treat initially with NSAIDS + physio
if that fails
straight to biologics -anti TNFa eg-etranacept/infliximab