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5_Rheum and Musc > Ankylosing Spondylitis > Flashcards

Ankylosing Spondylitis Flashcards

1
Q

Definition

A

Chronic inflammatory disease of spine and sacroiliac joints

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2
Q

Definition of ankylosis

A

Enthesitis between ligaments and vertebrae –> bony proliferations –> fuse with vertebral body above

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3
Q

Which HLA molecule is strongly correlated with AS?

A

HLA-B27

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4
Q

How many of those with AS are HLA-B27 positive?

A

88%

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5
Q

How many of those who are HLA-B27 positive develop AS?

A

6.5%

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6
Q

What percentage heritability is there with AS?

A

97%

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7
Q

Ratio of men:women affected

A

6: 1 (@ 16y/o)
2: 1 (@ 30y/o)

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8
Q

Pathophysiology

A

Inflammation
Erosions
Repair –> “ossification”

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9
Q

Symptoms and signs

A 
Inflammatory back pain --> decreased range of spinal movements
Acute iritis/uveitis
Enthesitis
IBD
Psoriasis
Fatigue
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10
Q

What are the common forms of enthesitis?

A

Achilles tendonitis

Plantar fasciitis

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11
Q

What are the typical features of inflammatory back pain?

A

Low back pain @ night (pt may wake up)
Early morning stiffness
Relieved by exercise and NSAIDs
Starts @ sacroiliac joints –> radiates to buttocks

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12
Q

To what may the symptoms progress to?

A

Kyphosis

Neck hyperextension

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13
Q

What bone disease are AS pts at an increased risk of getting?

A

Osteoporosis –> pathological fractures

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14
Q

Useful investigations

A

X-ray

MRI

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15
Q

What investigation is more sensitive to early inflammatory changes?

A

MRI

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16
Q

3 management options

A

Physiotherapy & exercise
NSAIDs
Steroid injections

17
Q

Why is physiotherapy essential?

A

Improves and maintains:
Posture
Flexibility
Mobility

18
Q

NSAIDs…

A

Improve spinal stiffness and pain @ all disease stages

19
Q

Indication for intra-articular steroid injections

A

Localised inflammation

20
Q

How to treat peripheral disease

A

DMARDs (e.g. sulfasalazine)

21
Q

How to treat refractory disease

A

Anti-TNFalpha (e.g. etanercept)

5_Rheum and Musc (4 decks)

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