Ankylosing Spondylitis CAT

Question 1

Ankylosing spondylitis AKA

Answer 1

Marie-Strumpell disease

Question 2

What is ankylosing spondylitis?

Answer 2

• Systemic condition characterized by chronic inflammation of the spine and larger peripheral joints
• Destroys ligamentous-osseous junction w/ subsequent fibrosis and ossification

Question 3

Which joints are commonly affected by AS?

Answer 3

• SI joint, intervertebral discs, spine, costovertebral and apophyseal joints
• Larger peripheral joints (hips, knees, and shoulders)

Question 4

Common demographics w/ AS?

Answer 4

• Men > women
• 20-40 years old

Question 5

Common clinical presentation w/ AS

Answer 5

Early on
- Recurrent and insidious episodes of LBP
- Morning stiffness
- Impaired spinal extension
- Limited ROM in affected joints

Advanced stages
- Pain increases in severity
- Pain progresses to midback/neck
- Loss of lordosis (due to muscle spasms)

Question 6

Labs/imaging for AS

Answer 6

• X-ray negative at first, visible as disease advances
• Blood work to rule out other diseases
• Elevated ESR

Question 7

Goals of medical management of AS

Answer 7

• Reduce inflammation
• Maintain functional mobility
• Relieve pain
• NSAIDs
• Indomethacin to relieve pain

Question 8

PT management of AS

Answer 8

• Postural exercises emphasizing extension, general ROM, pain management, and energy conservation
• Low-impact and aerobic exercise focusing on extension and rotation
• High-impact and flexion based exercise contraindicated

Question 9

What can occur with excessive exercise in patients w/ AS?

Answer 9

Increase of inflammation

Question 10

Which form of exercise is especially recommended for AS?

Answer 10

Swimming

Question 11

Sjogren’s syndrome

Answer 11

• Another spondyloarthropathy
• Usually found in combo w/ RA or lupus