Ankylosing Spondylitis Flashcards
1
Q
What genetic factor is associated with ankylosing spondylitis?
A
HLA-B27
2
Q
Describe the presentation of ankylosing spondylitis
A
Inflammatory back pain Early morning stiffness Resolution with NSAIDs Alternating buttock pain Waking in the second half of the night with back pain
3
Q
Describe the examination findings of ankylosing spondylitis?
A
Loss of lumbar lordosis on flexion Sacroilitis Kyphosis Peripheral joint involvement Increased tragus to wall distance
4
Q
What are the potential systemic features of Ankylosing spondylitis?
A
Iritis Uveitis Enthesitis Psoriasis IBD Dyspnoea Fatigue Sleep disturbance
5
Q
What investigation should be used for Ankylosing spondylitis?
A
X-ray pelvis - to show sacroilitis
or MRI if this is normal
6
Q
Describe the management of Ankylosing spondylitis?
A
Acute Management: NSAIDs physiotherapy Other non-pharmacological management, Intra-articular steroid injection Sulfasalazine / methotrexate - for peripheral joint involvement
Ongoing management of refractory disease:
1st line - TNF alpha, physiotherapy, NSAIDs
2nd line - secukizumab, ixekizumab, NSAIDs
7
Q
What are the potential complications of Ankylosing spondylitis?
A
Osteoporosis Cardiac involvement Hip involvement Iritis Pulmonary involvement Neurological involvement
