Ankylosing Spondylitis Flashcards
What is Ankylosing spondylitis?
Inflammatory condition that mainly affects the spine
What group of conditions is ankylosing spondylitis part of?
Seronegative spondyloarthropathy group of conditions
What gene is associated with ankylosing spondylitis?
HLA B27
What joints are typically affected by ankylosing spondylitis?
- Sacroiliac joint
* Joints of vertebral column
What is a characteristic feature of ankylosing spondylitis?
Bamboo spine
Who does ankylosing spondylitis usually affect?
Young adults
How long do symptoms take to develop in ankylosing spondylitis?
3 months
How does ankylosing spondylitis present?
- Lower back and stiffness
- Improves with movement
- May wake them from sleep
- Sacroiliac pain-in buttock region
- Flares of worsening symptoms
What causes the symptoms in ankylosing spondylitis?
Inflammation causing pain and stiffness in the joints which cause fusion of the spine and sacroiliac joints
What is the main way that ankylosing spondylitis is diagnosed?
X-ray
What would you see on an x-ray of ankylosing spondylitis?
- Syndesmophytes (bony growths can cause fusion of joint)
- Squaring of the lumbar vertebrae
- ‘Bamboo spine’
- Sacroiliitis (inflammation of the pelvis)
- Subchondral sclerosis (thickening of the bone)
What will schoberg’s test show in ankylosing spondylitis?
Reduced flexion
Reduced lordosis
What would you find in an MRI in Ankylosing spondylitis?
Romanus lesions in the bone marrow
What are the A features of Ankylosing Spondylitis?
- Apical fibrosis- upper zone
- Anterior uveitis
- Aortic regurgitation
- Achilles tendonitis
- AV node block
- Amyloidosis
What is the first line management of ankylosing spondylitis?
NSAID’s
What would you use to control the flares of ankylosing spondylitis?
Steroids
What is an Anti-TNF used to control in ankylosing spondylitis?
Disease activity
What Anti-TNF is used to manage disease activity in ankylosing spondylitis?
Infliximab
What is the criteria for using Anti-TNF’s in ankylosing spondylitis?
Use in axial ankylosing spondylitis that has failed on 2 different NSAIDS and meets criteria for active disease on 2 occasions 12 weeks apart
Who is more commonly affected by ankylosing spondylitis?
Young (20-30)
Males (3x)
How is chest expansion affected in someone with ankylosing spndylitis?
It is reduced
What non-pharmacological treatments are essential for people with AS to maintian mobility?
Exercise and physiotherapy
What needs to be prescribed along with an NSAID?
PPI
What do DMARD’s not do?
They do not improve spinal inflammation
