Ankylosing Spondylitis Flashcards
what is ankylosing spondylitis
chronic inflammatory disease of the spine and sacro-iliac joints
what can AS lead to
fusion of intervertebral and SI joints
is it more common in males or females
males 3:1
what is typical age of onset
20-40
what do patients complain of
- spinal pain and stiffness and may develop knee or hip arthritis
- spinal morning stiffness improved with exercise
what happens over time in AS
- loss of spinal movement
- development of “question mark” spine (loss of lumbar lordosis and increased thoracic kyphosis)
what test can be done for AS
Schober’s test
what does Schober’s test test
lumbar spine flexion
what does Schobers test entail
- measuring 5cm below posterior superior iliac crests and 10cm above when patient is upright
- ask them to bend forwards and distance should increase to at least 20cm
what conditions are associated with AS
anterior uveitis, aortitis, pulmonary fibrosis and amyloidosis
what can X-rays show
- sclerosis and fusion of sacro-iliac joints
- bony spurs from vertebral bodies (syndesmophytes)
what can cause “bamboo spine”
syndesmophytes bridging the intervertebral disc resulting in fusion
what can MRI’s pick up
earlier features e.g bone marrow oedema and enthesitis of spinal ligaments
what percentage of people are HLA B27 +ve
90%
what is treatment
physio, exercise, NSAID’s, anti-TNF for more aggressive disease
