ankylosing spondylitis Flashcards
1
Q
what
A
inflammatory condition affecting spine causing progressive stiffness and pain
2
Q
key joints affected
A
SI joints
joints of veretrbal columnbs
3
Q
what can it progress to
A
fusion of spine and SI joints (–> bamboo appearance on Xray)
4
Q
link with what gene
A
HLA B27
5
Q
typical presentation
A
young adult male symptoms develop gradually >3mo lower back pain and stiffness pain worse with rest morning stiffness
can have flare ups
6
Q
key complication
A
vertebral fractures
7
Q
associations
A
weight loss fatigue chest pain enthesitis dactylitis anaemia anterior uveitis heart block restrictive lung disease pulmonary fibrosis IBD
8
Q
Ix
A
CRP, ESR (may rise w disease activity)
HLA b27 test
xray
MRI
9
Q
what can spine MRI show
A
bone marrow oedema
10
Q
xray changes
A
bamboo spine squaring vertebral bodies subchondral sclerosis + erosions syndesmophytes ossification fusion
11
Q
Mx - medications
A
NSAIDs
steroids during flares
anti-TNF
secukinumab if NSAIDs and anti-TNF inadequate
12
Q
Mx - additional
A
physio
avoid smoking
bisphosphonates
13
Q
secukinumab
A
monoclonal antibody against IL-17
