Ankylosing Spondylosis And Pmr

Question 1

What is ankylosing sponylosis

Answer 1

Generalised chronic inflammatory disease

Question 2

Epidemiology and risk factors of ankylosing spondylosis

Answer 2

Affects mainly spine and SIJS
Female 1:2, male every 10
Onset 15-25 most common
Genetic background
Environmental factors, smoking

Question 3

Systemic effects of ankylosing spondylosis

Answer 3

Referred pain in SIJs, buttocks; alternating
Eyes- conjunctivitis
Hips, shhoulders and knees; inflammatory arthritis/ synovitis
Low grade fever, fatigue

Question 4

Clinical presentation of ankylosing spondylosis

Answer 4

Teen with reoccurring back pain and stiffness
Worse in the morning and following in activity
Referred pain in buttocks and thighs
Presentation becomes continuous
General fatigue and weight loss
Achilles tendon, intercostal pain
Loss of lumbar lordosis, increased throracic kyphosis
Decreased chest expansion
Peripheral joint involvement
Bamboo spine
Decreased rom
Morning stiffness greater than 30 minutes

Question 5

Pathology of ankylosing spondylosis

Answer 5

Synotivits of diathroid joints.
inflammatory reaction with round-cell infiltration , granulation tissue formation erosion of adjacent bone.
Replacement of granulation tissue by fibrous tissue
Ossification of fibrous tissue leading to ankylosing of spine

Question 6

Differential diagnosis of ankylosing spondylosis

Answer 6

Degenerative disc disease
Disc herniation
Oa
Spinal stenosis
Spondylosis
Ra

Question 7

Treatment and management of ankylosing spondylosis

Answer 7

HLA B27 -90%
Raises Esr (active)
X-ray- erosion, fuzziness of sijs
Surgery-
Lifestyle modifications- diet, exercise, posture
Medications- nsaids

Question 8

What is polymalgia rheumitica

Answer 8

Causes inflammation of the large muscles of the body, accompanied by systemic symptoms including malaise, fatigue, fever and weight loss.
The synovial membranes that line and lubricate the joints become inflamed, causing pain and discomfort

Question 9

Polymalgia rheumitica epidemiology and risk factors

Answer 9

Most commonly affects over 50, rare under 50
Prevalence increases with age
Most common in women
Caucasians at a higher risk
Some cases suggest that infections/ disease expose could be environmental
Inheritance- genetic patterns

Question 10

Clinical presentation of polymalgia rheumitica

Answer 10

Bilateral shoulder pain
Pelvic girdle pain and stiffness, worse in the morning
Fatigue
Low grade fever
Weight loss
Duration of stiffness over 45 minutes
Pain in the lower back, buttock and thighs.
Less rom in affected joints
Upper arm tenderness
Stiffness In wrists

Question 11

Pathology of polymalgia rheumitica

Answer 11

Exact cause in unknown
Inflammatory condition, affecting the synovial of proximal facets and bursae
Individuals immune system overactivity
Often associated with giant cell arthritis

Question 12

Systemic affects of polymalgia rheumitica

Answer 12

Stiffness in the morning, more than 30 mins
Weakness, fatigue, malaise
Low grade fever, sweats, headaches, weight loss
Depression
Vision changes

Question 13

Differential diagnosis of polymalgia rheumatica

Answer 13

Ra
Spondyloarthropathy
Fibromyalgia
Oa
Giant cell arthritis

Question 14

Treatment, diagnosis of polymalgia rheumitica

Answer 14

Calcium c and d supplements
Consider anti inflammatory diet,
Lifestyle modifications
Physical therapy