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ankyl. spondylitis
database/managment ankyl. spondylitis
| Question | Answer |
|---|---|
| Description: ankylosing spondylitis | rheumatic disease, seronegative spondyloarthropathy chronic systemic inflammatory d/o of axial skeleton (sacroiliac joints & spine) |
| Types: ankylosing spondylitis | primary/uncomplicated secondary which includes reactive arthritis (Reiter syndrome), psoriatic arthritis, enteropathic arthritis (ulcerative colitis, Crohn’s disease) |
| Organs involved: ankylosing spondylitis | primary-spine, peripheral joints, periarticular structures secondary-eyes, skin, GI, heart |
| Who is most affected?: ankylosing spondylitis | young men 3X > women onset <30-40 yrs |
| Incidence/Prevalence: ankylosing spondylitis | #1 spondyloarthropathy uncommon disease-0.1%-0.2% prevalence in white North Americans 1%-2% of 6% population with HLA-B27 |
| Pathogenesis: ankylosign spondylitis | ligamentous inflammatory granulation tissue that is gradually replaced by fibrocartilage and then ossifies |
| Risk Factors: ankylosing spondylitis | strong association with HLA-B27 90% Caucasian pt & 50% black pt has HLA-B27 FH of inflammatory bowel disease and/or ankylosing spondylitis |
| Complications: ankylosing spondylitis | Visual loss Neurologic-cord compression, spinal fracture, atlantoaxial subluxation (dislocation), cauda equina syndrome CVS-aortic problems Pulmonary problems-fibrosis, restrictive lung disease Bone disease-osteoporosis |
| CC & HPI: ankylosing spondylitis | Pain and/or stiffness in back, diffuse pain, sciatic pain, eye pain, increase lacrimation Gradual onset, SI joint involved first, later rigidity, worse in AM or with inactivity, episodic at first but becomes chronic |
| PHM: snkylosing spondylitis | FH of alcoholism, depression, RA, lupus or other autoimmune disorder SH-limitations to fxn at work, home |
| ROS: ankylosing spondylitis | Skin-rash, hair loss HEENT- Sicca symptoms, Uveitis Respiratory-Pleurisy CVS-Chest pain GI-diarrhea Neurologic-siatica |
| Physical assessment: general & HEENT: ankylosing spondylitis | General-pt unable to bend over, rigid gait, flexion contractures in hip & knees, tenderness sacral, iliac, & lumbar regions HEENT-irits, circumcorneal congestion CVS-heart murmur |
| Physical assessment: lungs, back, extremities: ankylosing spondylitis | Lungs-limited chest expansion Back-stiff back begins at SI joint, limited forward flexion; Schober test reveal flattened lumbar curve with patient erect & minimal true lumbar flexion, decrease spine mobility as measured by Moll’s lateral flexion test |
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