Rhamtalogy Flashcards
Axial Spondyloarthritis (AxSpA)
Definition
Axial spondyloarthritis (AxSpA) is a chronic inflammatory rheumatological condition primarily affecting the spine and sacroiliac joints, often presenting with back pain and stiffness.
Key Features
Chronic back pain (lasting ≥3 months)
Morning stiffness lasting ≥30 minutes
Improvement with movement, not rest
Night pain that improves upon getting up
Alternating buttock pain
Associated conditions: IBD, psoriasis, uveitis
Axial Spondyloarthritis
Management
Medication: NSAIDs, biologics (e.g., TNF inhibitors)
Exercise & Physiotherapy: Focus on mobility, strength, and flexibility
Lifestyle: Smoking cessation, stress reduction
Axial Spondyloarthritis
Subjective Inflammatory Questioning (Key Questions to Ask Patients)
Pain History
When did the pain start?
Is the pain worse in the morning or after rest?
Does movement improve or worsen your symptoms?
Stiffness
How long does your morning stiffness last?
Activity Impact
Can you remain active, or does rest help?
Sleep Disturbance
Does the pain wake you at night?
Other Symptoms
Have you experienced swelling, skin conditions (e.g., psoriasis), or eye issues (e.g., uveitis)?
Exercise Programme Design for Rheumatological Conditions
Key Principles
Individualisation
Tailor exercises to the patient’s ability, pain levels, and functional goals.
Progression
Gradually increase intensity, duration, and complexity.
Balance of Rest and Movement
Encourage regular movement to reduce stiffness without over-exertion.
Joint Protection
Use low-impact exercises to minimize strain.
Functional Training
Focus on improving daily activities and independence.
Water-Based Exercise Programme
Benefits:
Reduces joint load and pain
Improves mobility and cardiovascular fitness
Sample Programme:
Warm-up: Gentle stretching in warm water (5-10 mins)
Cardiovascular: Water walking, jogging (10-15 mins)
Strength: Resistance bands or pool noodles for upper and lower limb strengthening (10 mins)
Flexibility: Gentle stretches to improve range of motion (5-10 mins)
Cool-down: Breathing exercises and relaxation (5 mins)
What does DMARDs stand for and what are these drugs used for?
a) Disease-modifying antirheumatic drugs. indicated for the treatment of several inflammatory arthritides, including rheumatoid arthritis (RA), as well as for the management of other connective tissue diseases and some cancers. E.g., •Hydroxychloroquine®Methotrexate•Sulfasalazine
Demonstrate a clinical assessment for a patient presenting with inflammatory symptoms.
•Nails and skin
•Hands and wrists
•Peripheral Joints
•Spine and hip range of movement
•Palpation of spine & Sacro Iliac (SI) Joints
•Palpation of entheses
• Neuro integrity
