Ankylosing Spondylitis def., causes, pathology, clinical picture

This article is to discuss Ankylosing Spondylitis (AS) regarding its medical definition, Aetiology (Causes and incidence), Pathogenesis and clinical picture (symptoms and signs). Investigations, Differential diagnosis and treatment are discussed later .

This article is to discuss Ankylosing Spondylitis (AS) regarding its medical definition, Aetiology (Causes and incidence), Pathogenesis and clinical picture (symptoms and signs).
Investigations, Differential diagnosis and treatment are discussed later .
Definition
It is an inflammatory arthropathy starting in the sacroiliac and spinal joints with tendency to ankylosis of the axial skeleton.

Causes and incidence of Ankylosing Spondylitis 

• The prevalence is about 0.2% of the general population.
• Age of onset: 15 - 40 years.
• Sex:  male : female  = 3 : 1
• HLA - B27 association (95% of patients have HLA-827).
• High incidence of prostatic infection by klebsiella
So, there may be an association between this disease and klebsiella infection .

pathology of Ankylosing Spondylitis

1- Vertebrae become square shaped due to erosion of their corners.
2- Periosteal reaction with new bone formation around vertebrae (bony bridging) = Syndesmophytes (osteophytes) spread up and down from vertebral body with fusion ==> bamboo spin
3- Calcification of anterior longitudinal ligament.
4- Extra-articular lesions:
   - Aortic valve (Aortitis) ===>  fibrosis at valve base ==> Aortic incompetence
   - Lung? upper lobe fibrosis.
   - Iritis in 25% of patients.
- Amyloidosis of kidney ==> nephrotic syndrome.
Ankylosing-Spondylitis

Clinical picture 

• The onset is usually insidious over months or years with recurring episodes of low back pain and stiffness sometimes radiating to buttocks or thighs, improved with movement.
1- Vertebral column .
    • Limited lumber movement.
    • Chest pain aggravated by breathing results from affection of costovertebral joints.
    • Neck pain.
    • Atlanto - axial sublaxation.
2- Enthesopathy
     • Inflammation at the site of ligamentous insertion. e.g. Achilles tendenitis.
3- Peripheral joint
       •  Asymmetrical arthritis.
       • Shoulder and hi joint are usuall affected.

 Sacroiliits lead to low back ache. it is tested by pushing the sacrum forward.

4- Extra-articular manifestations
• Amyloidosis kidney.
• Aortic incompetence, cardiac conduction defects, pericarditis.
• Apical lung fibrosis.
• Prolonged fever.
• Uveitis.

How can you differentiate between mechanical and inflammatory back ache e.g AS?

1- Character of pain.
Inflammatory : +++ at night, it is improved by movement.
Mechanical    : +++ with movement and improved with rest.
2- Laboratory findings.
- ESR, CRP +++ in inflammatory back ache.
Schober test
Schober-test









Ankylosing spondylitis differential diagnosis, investigations,prognosis, treatment

COMMENTS

BLOGGER
Name

andrology,2,Cardiology,10,Differential-diagnosis,5,E.N.T,18,General Surgery,4,General-Health,6,GIT,19,Gynecology,1,Hepatology,8,Internal-medicine,1,Microbiology,2,Orthopedics,1,Psychiatry,3,Respiratory-diseases,59,Rheumatology,50,STDs,3,Symptomatology,9,Urology,36,
ltr
item
Med2Date: Ankylosing Spondylitis def., causes, pathology, clinical picture
Ankylosing Spondylitis def., causes, pathology, clinical picture
This article is to discuss Ankylosing Spondylitis (AS) regarding its medical definition, Aetiology (Causes and incidence), Pathogenesis and clinical picture (symptoms and signs). Investigations, Differential diagnosis and treatment are discussed later .
http://2.bp.blogspot.com/-k4Z3nMV2-Oc/Ue6oKFpDWYI/AAAAAAAAEaU/Ozxh6lehyNs/s200/Ankylosing-Spondylitis-pathology.png
http://2.bp.blogspot.com/-k4Z3nMV2-Oc/Ue6oKFpDWYI/AAAAAAAAEaU/Ozxh6lehyNs/s72-c/Ankylosing-Spondylitis-pathology.png
Med2Date
http://www.med2date.com/2013/07/ankylosing-spondylitis-manifestation.html
http://www.med2date.com/
http://www.med2date.com/
http://www.med2date.com/2013/07/ankylosing-spondylitis-manifestation.html
true
1129835733813637495
UTF-8
Loaded All Posts Not found any posts VIEW ALL Readmore Reply Cancel reply Delete By Home PAGES POSTS View All RECOMMENDED FOR YOU LABEL ARCHIVE SEARCH ALL POSTS Not found any post match with your request Back Home Sunday Monday Tuesday Wednesday Thursday Friday Saturday Sun Mon Tue Wed Thu Fri Sat January February March April May June July August September October November December Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec just now 1 minute ago $$1$$ minutes ago 1 hour ago $$1$$ hours ago Yesterday $$1$$ days ago $$1$$ weeks ago more than 5 weeks ago Followers Follow THIS CONTENT IS PREMIUM Please share to unlock Copy All Code Select All Code All codes were copied to your clipboard Can not copy the codes / texts, please press [CTRL]+[C] (or CMD+C with Mac) to copy