Ankylosing Spondylitis Flashcards
what are the spondyloarthropathies
associated with the HLA B27 gene
affecting the spine and peripheral joints
Ankylosing spondylitis (most common), psoriatic arthritis and reactive arthritis
describe Ankylosing spondylitis
progressive inflammatory condition of the spine
which are the most common joints affected in Ankylosing spondylitis
sacroiliac joint
joints of the vertebral column: facet joints and intervertebral joints
presentation of Ankylosing spondylitis
most commonly presents in younger men
gradual onset of lower back pain and stiffness , bilateral buttock pain, chest wall and thoracic pain
stiffness improves throughout the day
fluctuating symptoms
what are some associated / systemic symptoms of ankylosis spondylitis
weight loss and fatigue
chest pain
enthesitis
dactylytitis
anaemia
anterior uveitis
aortitis
heart block
restrictive lung disease
IBD
which test can be used to look for Ankylosing spondylitis
schobers test
<20cm would suggest lumbar spine restriction and support diagnosis of Ankylosing spondylitis
what investigations can you use for Ankylosing spondylitis
inflammatory markers
genetic test - HLA B27
XR
MRI - bone marrow oedema
what are some XR findings for Ankylosing spondylitis
squaring of the vertebral bodies
subchondral sclerosis and erosions
ossifications of the ligaments, discs and joints
fusion of the facet joints, sacroilliac joins and costovertebral joints
syndesmophytes (bone growth where ligaments insert)
what are the medical management options for Ankylosing spondylitis
NSAIDs (first line)
steroids (PO, IM or joint injection) during flares
anti-TNF (only if failed to respond to 2 different NSAIDs)
last line is secukinumab
what are some anti-TNF medications
etanercept
infliximab
adalimumab
what are some supportive management options for Ankylosing spondylitis
physiotherapy
smoking cessation
bisphosphonates
treatinng complications
