Spondyloarthritis

Question 1

Earliest radiological appearance of ankylosing spondylitis in spine?

Answer 1

Blurring of the upper and lower vertebral rims at the thoracolumbar junction (best seen on a lateral x-ray)
-this is caused by enthesitis at the insertion of the intervertebral ligaments

Question 2

What is a syndesmophyte?

Answer 2

A syndesmophyte is a bony growth originating inside a ligament, commonly seen in the ligaments of the spine
-in ankylosing sphondylitis, they cause bony ankylosis and permanent stiffening

Question 3

What is bamboo spine?

Answer 3

Calcification of the intervertebral ligaments and fusion of the spinal facet joints and syndesmophytes

Question 4

Most common pattern of psoriatic arthritis?

Answer 4

Distal interphalangeal arthritis

Pencil in cup!!

Question 5

Allele common in spondyloarthritis?

Answer 5

HLA-B27

Question 6

Common age and gender affected in Spondyloarthritis?

Answer 6

Males, late teens-early 30’s

Question 7

Non-spinal complications associated with spondyloarthritis?

Answer 7

Uveitis and Costochondritis

Question 8

Treatment of Ankylosing Spondylitis

Answer 8

NSAID (improve sleep, pain control and exercise compliance)
Methotrexate for peripheral arthritis (not effective in spinal disease)
TNF alpha blocker ADALIMUMAB has changed lives

Question 9

Percentage risk of passing HLA-B27 to children if you have ankylosing spondylitits?

Answer 9

50%

Question 10

A syndesmophyte is a bony growth originating in a what?

Answer 10

Originates in the ligament ;)