Ankylosing Spondylitis Flashcards
What is Ankylosing Spondylitis ?
This is inflammation affecting the SI joints and the spine.
Who is more predisposed to Ankylosing Spondylitis ?
Young Caucasian males presenting with back pain may wake up during the night.
How would patients present ?
Stiff back with reduced lordosis and reduced lateral flexion movement.
What are the radiographic appearances of Ankylosing Spondylitis ?
1) Sacroiliitis - Bilateral and Symmetrical. Affects the lower third of the sacroiliac joints first. Loss of joint margins, erosions, joint space widening and sclerosis can all be seen. As the disease progresses the joint spaces become less defined and ankylose.
2) Spondylitis - Erosions and new bone formations. This new bone formation along the anterior aspect of the spine causes a squared appearance. Then will eventually become fully Ankylosed.
3) Reduced bone density
What are Romanus lesions in association to Ankylosing Spondylitis ?
Erosions seen on the superior and inferior vertebral endplates
What is the Shiny Corner sign in association to Ankylosing Spondylitis ?
Reactive sclerosis/ healing to erosions develop a shiny corner sign.
What is the dagger sign in association to Ankylosing Spondylitis?
Ligamentous calcification of the Posterior aspect of the SI joints (the Posterior interspinous ligament).
What are the risks associated with Ankylosing Spondylitis ?
Fracture is a high possibility with minor trauma. This is due to spinal fusion and reduced bone density.
As the spine is fused any fracture is likely to be a three column injury.
What is the distribution of Ankylosing Spondylitis ?
Axial skeleton. Sometimes affects medium and large joints.
What group of diseases is Ank Spond in and why ?
Seronegative HLA-B27 positive Spondyloarthropathy.
What other diseases are part of the seronegative B-27 Spondyloarthropathy group ?
PSA
Reiter’s syndrome
Inflammatory Bowel disease.
What disease is associated with unilateral SI joint space sclerosis and narrowing ?
Psoriasis or reiters syndrome.
Ank spond and inflammatory disease won’t have that distribution.
What is Reiter’s syndrome ?
A type of arthritis caused by infection.
