Joint Disorders - A-SPONDYLITIS

Question 1

What is Ankylosing Spondylitis:

Answer 1

chronic progressive inflammatory disorder

affects sacroiliac joints
invertebrate spaces
costovertebral joints of axial skeleton

Question 2

In what way does Ankylosing Spondylitis affect women to a greater extent than men?

Who is the disorder more common in?

Answer 2

women have peripheral joint involvement to a greater extent

Question 3

Peripheral Joint

Answer 3

( joints not in the area of the spine, eg shoulder, knee, ankle) .

Question 4

At what age does Ankylosing Spondylitis?

Answer 4

usually develops in persons 20 to 30yrs age and varies in severity

Question 5

What marks the course of Ankylosing Spondylitis?

Answer 5

remissions and exacerbations

Question 6

What is the cause of Ankylosing Spondylitis?

Answer 6

not yet fully determined
deemed autoimmune disorder w genetic basis
(given presence HLA-B27 antigen in serum of most patients

Question 7

Pathophysiology Ankylosing Spondylitis:

Answer 7

vertebral joints first become inflamed

fibrosis, calcification = fusion = ankylosis/fixation joints=loss mobility.

inflammation begins lower back at sacroiliac joints, progresses up spine eventually = ‘poker back’

kyphosis develops - postural changes necessitated by rigidity + loss norm spinal curvature
osteoporosis common - may = kyphosis due pathological compression fractures of vertebrae
lung expansion limited as calcification of costovertebral joints reduces rib movemen

Question 8

Calcification

Answer 8

accumulation calcium salts in body tissue
normally occurs in the formation of bone, b
ut calcium can be deposited abnormally in soft tissue, causing it to harden.

classified on whether there is a mineral balance or not, and the location of the calcification

Question 9

Fixation (of Joints)

Answer 9

adhesions

any two vertebrae that make up one joint can get “glued together” and not have available their normal movement

Question 10

Sacroiliac Joints

Answer 10

(SIJ)

joint between sacrum and ilium bones of pelvis

Question 11

Initial:
Signs and Symptoms:
Ankylosing Spondylitis

Answer 11

• low back pain
• morning stiffness
• pain more marked - lying down, may radiate to legs similar to sciatic pain, discomfort relieved by walking or mild exercise

Question 12

As Calcification develops
Signs and Symptoms:
Ankylosing Spondylitis

Answer 12

• rigid spine
• flex, ext, rotation spine - impaired
• sytemic signs
• uveitis, iritis

Question 13

What proportion of Ankylosing Spondylitis pts develops systemic signs?

Answer 13

some individuals (1/3) systemic signs e.g.
fatigue
fever
weight loss

Question 14

Uveitis

Answer 14

inflammation middle layer the eye
uvea or uveal tract

eye pain, changes to vision

most cases better w tx– usually steroid medicine
sometimes = further problems glaucoma, cataracts

Question 15

Iriti

Answer 15

inflammation iris
can cause…
eye pain, light sensitivity, headache, decreased vision

can = serious problems…
severe vision loss
blindness.

Infection, injury, and autoimmune disease are major causes

Question 16

Tx:

Answer 16

relief of pain
maintenance mobility
sleeping - supine - reduces the tendency to flexion
appropriate daily exercise - promotes muscle support, proper posture
antiinflammatory drugs - useful during exacerbations