Ankylosing Spondylitis Flashcards Preview

Osteo And Rheum > Ankylosing Spondylitis > Flashcards

Flashcards in Ankylosing Spondylitis Deck (19)
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1
Q

Cause?

A

Unknown

2
Q

More common in which sex? Which presents earlier?(specify average age)

A

Males - present at 16 (women present in their 30s)

3
Q

What is the HLA system?

A

A key system that plays a role in self-recognition and immunity

4
Q

Which HLA gene is present in 90% of those with AS?

A

HLA B27

5
Q

What is the typical presentation?

A

A male

6
Q

Where does pain occur mostly and when is it relieved?

A

In the sacro-iliac joints and radiates to the hips and buttocks

Relieved by the end of the day

7
Q

There is progressive loss of what?

A

Spinal movement and as a result reduces thoracic expansion

8
Q

Can eventually progress to what bone deformities?

A

Kyphosis, neck hyper extension, spins-cranial ankylosis, enthesitis (inflammation at site of insertion of tendon/ligament to bone)

9
Q

What other conditions might those affected develop?

A

Anterior Mechanical chest pain due to chostochondritis, acute irititis, osteoporosis

10
Q

How is the diagnosis reached?

A

Clinically with supportive imaging

11
Q

What is the most sensitive rest for AS?

A

MRI

12
Q

What might be seen on a radiograph?

A

Sacroilitis, erosions, irregularities, sclerosis, syndesmophytes (T11-L1 esp) are characteristic

Late disease: syndesmophytes fuse and spine is fused together by ossification to cause “bamboo spine”

13
Q

What might the blood tests show?

A

Normocytic anaemia, raised CRP, raised ESR

14
Q

What other test might you do to corroborate your findings?

A

Genetic testing for HLA B27

15
Q

Managements?

A

Intense exercise regimen, NSAIDs, TNF alpha blockers (if NSAIDs fail), steroid injections, bisphosphosphonates for any osteoporosis

16
Q

What surgery may help to relieve pain in those suffering from severe pain?

A

Hip replacement

17
Q

Prognosis?

A

Very variable, can be periods of remission with little disability and then periods of inflammation where very disabled. High association with death by circulatory diseases

18
Q

What factors may suggest a poor diagnosis?

A

ESR >30 (normal = 0-15 in men and 0-20 in women under 50), onset under 16 years, poor response to NSAIDs

19
Q

What is it?

A

A chronic inflammatory disease of the spine and sacro-iliac joint (axial skeleton)