Ankylosing spondylitis

Question 1

Associated with HLA

Answer 1

HLA-B27 associated spondyloarthropathy.

Question 2

stiffness is usually worse in the […] and improves with […]
the patient may experience pain at […] which improves on getting up

Answer 2

stiffness is usually worse in the morning and improves with exercise
the patient may experience pain at night which improves on getting up

Question 3

line is drawn 10 cm above and 5 cm below the back dimples (dimples of Venus). The distance between the two lines should increase by more than 5 cm when the patient bends as far forward as possible

Answer 3

Schober’s test`

Question 4

The As of Ank Spond

Answer 4

Apical fibrosis
Anterior uveitis
Aortic regurgitation
Achilles tendonitis
AV node block
Amyloidosis
cAuda equina

Question 5

Invx

Answer 5

ESR and CRP
XRay SI joints (if not good, then MRI)
Spirometry –> fibrosis + kyphosis and ankylosis
Echo if cardiac symptoms –> aortic regurg

Question 6

Mx of Ank Spond

Answer 6

Exercise
NSAIDs
Anti-TNF therapy
If peripheral involvement –> DMARDs e.g. sulphasalazine