Ankylosing spondylitis

Question 1

What is Ankylosing Spondylitis?

Answer 1

Inflammation of the spine causing progressive stiffness and pain. HLA-B27 seronegative (+reactive and psoriatic arthritis)
Attacks type 1 and type 2 collagen.

Question 2

most commonly affected joints?

Answer 2

Sacroiliac joints, joints of vertebral column.

Question 3

Risk factors?

Answer 3

90% have HLA-B27

1st degree relative

Question 4

X-ray findings

Answer 4

Bamboo spine.
Syndesmophytes - areas of bone growth.
fusion of facet joints, sacroiliac and costovertebral.

Question 5

Complications?

Answer 5

Vertebral fractures.

Question 6

Other symptoms?

Answer 6

weight loss, fatigue, chest pain, enthesitis,

Question 7

Other symptoms?

Answer 7

weight loss, fatigue, chest pain, enthesitis, anaemia, uveitis, dactylics, aortitis, PULMONARY FIBROSIS, IBS.

Question 8

Classification criteria?

Answer 8

<45 yrs

> 3 months

Question 9

what is examination?

Answer 9

Schobers test - for mobility.. starts at 15cm apart, if once they bend its <20cm - theres restricted movement.

Question 10

What are the early changes?

Answer 10

MRI - shows oedema of the vertebral bodies (before X-ray changes appear).

Question 11

Management?

Answer 11

1st - NSAIDS (ibuprofen or niproxan)
steroids - for flare ups.
Anti TNF - atanacept, infliximab.
DMARD’s.