Ankylosing spondylitis Flashcards

1
Q

What?

A

Chronic inflammatory disease of spine & sacro- iliac joints

Can lead to eventual fusion of intervertebral & SI joints

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2
Q

Who?

A

Males> women

20-40 years

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3
Q

Presentation?

A
Back pain (SI joints)
Enthesitis
Peripheral arthritis
Spinal morning stiffness improves with exercise
"Questions mark spine"
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4
Q

Question mark spine?

A

Loss of lumbar lordosis and increases thoracic kyphosis

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5
Q

Extra- articular features?

A
Anterior uveitis
CV involvement
Pulmonary involvement 
Asymptomatic enteric mucosal inflammation
Neurological involvement
Amyloidosis
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6
Q

“A” disease?

A
Axial Arthritis
 
Anterior Uveitis 
Aortic Regurgitation 
Apical fibrosis 
Amyloidosis/ Ig A Nephropathy 
Achilles' tendinitis 
Plantar Fasciitis (inflammation of plantar fascia – part of foot which connects heal bone to toes)
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7
Q

Diagnosis - examination?

A

Tragus/ occiput to wall
Chest expansion
Schober test

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8
Q

Investigations?

A

Bloods (inflammatory parameters, HLA-B27 positive (often))
Xrays
MRI

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9
Q

X- ray changes?

A
Show changes after long time 
Sacroiliitis 
Syndesmophytes (bony spurs from vertebral bodies) 
Sclerosis & fusion of sacroiliac joints 
Erosions  
“Bamboo” spine  
If not had for long, X-ray may be normal
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10
Q

MRI findings?

A

Earlier features
Bone marrow oedema
Enthesitis of spinal ligaments
Not needed for diagnosis if Xray confirms

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11
Q

Classification?

A

ASAS classification

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12
Q

Management?

A

NSAIDs
Physiotherapy
Exercise
Anti- TNF for more aggressive disease (if spinal pain score >4 eligible for this, if first line medication and physiotherapy not worked for 3 months)

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