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Flashcards in Ortho Deck (10):
1

Ankylosing Spondylitis Diagnostic Criteria
(Rev)

Modified New York criteria (1994)
Clinical
1. LBP or stiffness >3m that improves with exercise but not with rest
2. Limitation of lumbar spine mobility (frontal and sagittal)
3. Limitation of Chest expansion

Radiological
1. Unilateral sacroiliitis of grade 3-4
2. Bilateral sacroiliitis of grade 2 or more

Definite AS
Radiological criteria + 1 clinical criterion

Probable AS:
All 3 clinical criteria but no radiological criteria //
Radiological criteria but no clinical criteria

2

AS X ray features (Pelvis, Spine)

AP Pelvic
- Sacroilitis: Erosion, reactive bone, decreased joint space and fusion (Lower portion first)
- Hip joint fusion

Spine
- Paravertebral ossification and syndesmophytosis "Bamboo spine"
- Erosion of vertebrae "squaring of vertebrae"
- Osteoporosis
- Disc and apophyseal joint narrowing

3

AS PE findings

- Decreased lumbar lordosis, increased C and T kyphosis

- Decreased lumbar motion (Schober test <20%)

- Decreased chest expansion

- Positive Patrick's test (aka FABER test)

- Chin-brow to vertical angle (stand with hip and knee extended)

- Hip and knee contracture, peripheral joint

4

AS Mx

Conservative
- Pharm (symptomatic, ?DMARD)
- Exercise

Operative
- Always hip first
- L-spine
- C-spine C7/T1

5

Galeazzi fracture

#Distal radius w/ dislocation of the distal radioulnar joint (DRUJ)

6

Monteggia fracture

#Proximal ulna w/ dislocation of the proximal DRUJ

7

Colles fracture

#Distal radius w/ dorsal displacement

8

Smith fracture

#Distal radius w/ ventral displacement

aka Reverse Colles

9

Barton fracture

#Distal radius into wrist joint (Intra-articular extension)

10

AS pathogenesis

Fibrosis & ossification of ligament & capsule attachment

Inflammatory arthritis of spine, SIJ & peripheral joint (mainly hip & shoulder)

Cartilage destruction, bony erosion & fusion

Primary @ ligament, tendon & capsule attachment

Fibrinoid necrosis of discovertebral junction

Costovertebral ankylosis

Pulmonary fibrosis, decreased lung function

Extraskeletal tissue: eye, lung, heart, kidney, cauda equina, GIT