Rheumatology - Ankylosing Spondylitis Flashcards
What conditions are part of the seronegative spondyloarthropathy group?
Ankylosing spondylitis
Reactive arthritis
Psoriatic arthritis
What are the main affected joints in AS?
Sacroiliac joints
Vertebral column joints
Can progress to joint fusion
What gene is associated with AS?
HLAB27
How does AS typically present?
Symptoms develop over 3 months
- Pain and stiffness in lower back
- Sacroiliac pain
- Pain worse at night and can wake then up
- Improves with activity over rest
What additional symptoms of AS are there?
Chest pain (costovertebral and sternocostal joints)
Achilles tendonitis
Plantar fasciitis
Dactylitis
Vertebral fractures
SOB
What are the 5 associations of AS?
Anterior uveitis
Aortic regurgitation
Atrioventricular block
Apical lung fibrosis
Anaemia of chronic disease
What test is done for AS?
Schober’s test
Under 20cm indicates AS
What investigations are used for AS?
CRP and ESR
HLAB27
X-ray of spine
MRI of spine can show bone marrow oedema
What is the typical x-ray finding in later stages of AS?
Bamboo spine
Fusion of sacroiliac and spinal joints
What do x-rays in AS show?
Squaring of vertebral bodies
Subchondral sclerosis and erosions
Syndemophytes
Ossification of ligaments
Fusion of facet, sacroiliac and costovertebral joints
How is AS managed?
NSAIDs
Anti-TNFs
Secukinumab
Intra-articular steroid injections for specific joints
Physiotherapy
Smoking cessation
Surgery
Bisphosphonates
Exercise
