Ankylosing Spondylitis Flashcards
Cause?
Unknown
More common in which sex? Which presents earlier?(specify average age)
Males - present at 16 (women present in their 30s)
What is the HLA system?
A key system that plays a role in self-recognition and immunity
Which HLA gene is present in 90% of those with AS?
HLA B27
What is the typical presentation?
A male
Where does pain occur mostly and when is it relieved?
In the sacro-iliac joints and radiates to the hips and buttocks
Relieved by the end of the day
There is progressive loss of what?
Spinal movement and as a result reduces thoracic expansion
Can eventually progress to what bone deformities?
Kyphosis, neck hyper extension, spins-cranial ankylosis, enthesitis (inflammation at site of insertion of tendon/ligament to bone)
What other conditions might those affected develop?
Anterior Mechanical chest pain due to chostochondritis, acute irititis, osteoporosis
How is the diagnosis reached?
Clinically with supportive imaging
What is the most sensitive rest for AS?
MRI
What might be seen on a radiograph?
Sacroilitis, erosions, irregularities, sclerosis, syndesmophytes (T11-L1 esp) are characteristic
Late disease: syndesmophytes fuse and spine is fused together by ossification to cause “bamboo spine”
What might the blood tests show?
Normocytic anaemia, raised CRP, raised ESR
What other test might you do to corroborate your findings?
Genetic testing for HLA B27
Managements?
Intense exercise regimen, NSAIDs, TNF alpha blockers (if NSAIDs fail), steroid injections, bisphosphosphonates for any osteoporosis
