spondyloarthritis Flashcards
is there a RF in seronegative spondylorarthris
no
common features of spondyloarthritis
inflammation of spine synovitis enthesopathy inflammatory eye no RF tendency to be hereditary
does spondyloarthritis effect legs or arms more
legs
spondyloarthritis associated with __ genetic marker
HLA B27
Psoriatic Arthritis
psoariasis multigenetic inheritence can begin in childhood dactylitis enthesitis
dactylitis
sausage like fingers and toes due to swelling
enthesitis
tendon attaches to bone (heals / back)
psoriatic arthritis categories
spinal
or peripheral
enteropathic spondylitis aka
intestinal arthropathy
enteropathic spondylitis associated with
ulcerative colitis / crohns disease
arthritis
may effect spines / SI joint or arm/legs
reactive arthritis associated with
generally symmetrical
hot , swollen joints
lower limbs
stiffening in spine
reactive arthritis triggered by
infection bowel / Genito URINARY tract
ankylosing spondylitis associated with
stiffness / fusing of spine by inflammation
young adults
delay in diagnosis
t/f ankylosing spondylitis rare beyond 45
t
prevalence of ankylosing spondylitis male female
1:1
features of ankylosing spondylitis
sacroilitpis
enthesitis
synovitis
eyes, bowel, lung or heart may be involved
hallmark sign of ankylosing spondylitis
sacroilitis
sacroilitis
deep dull diffuse pain in buttock
bilateral
enthesitis at risk of
risk of fractures
osteoporosis
modified New York criteria for AS
low back pain for more than 3 months (better w exercise, not rest)
limited lumbar spine motion
limited chest expansion
clinical features spondyloarthrits
pain after rest stiff in AM decreased spine ROM deformity / instability dec strength altered breathing mechanics
inflammatory back pain vs mechanical - w exercise?
inflam - improves with exercise
mech - worsens
inflammatory back pain vs mechanical - pain
inflam - EARLY AM
mech - later in day
inflammatory back pain vs mechanical - AM pain
inflam - prolonged
mech - less than 40 mins
criteria for inflammatory LBP
> 3 months
improves w exercise
pain at night
no improvement w rest
how to do objective of spondarthritis assessment
- tragus to wall
- side flexion both sides
- PSIS 10 up and 5 down and bend (Schobers)
- smythe (10 up from PSIS three times)
- rotation, chest breath
- tragus to acromion
- chin to tip of clav
what test measures flexion
schobers
what test measures ext
smythe
management for spondyloarthrits
meds
physical intervention
lifestyle
surgery
meds for spondyloarthrits
NSAIDS
DMARDS
are DMARDS effective in axial disease
no
side effects of DMARDS
nausea vomitting rashes hair loss
NSAID side effects
GI upset, bruising, headache, drowsiness
PT for spondyloarthrits
start ASAP use outcome measures lifelong regular exercise flexibility / breathing exercises PT modalities
outcome measures for spondyloarthrits
physical assessment
posture, trunk flexion, schooners, smythe, rotation, chest expansion, cervical mobility
how to control inflmmation
rest
ice compress
exercise
target areas exercise spondyloarthrits
pecs
neck posture
tspine
pelvis (hip flexors, adducts, quads, hams)
adapted equipment for spondyloarthrits
swivel chair
back support
rear view mirrors
