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Ankylosing Spondlyitis Cheat Sheet by

Info on seronegative spondyloarthropathies, including Sx, Ix, Dx, Mx

Background Inform­ation

Inflam­matory condition mainly affecting the spine, causing fusion
Causes stiffness and pain
Main joints involved = SI joints and vertebral column
90% have HLA-B27 gene

Invest­iga­tions

Raised CRP + ESR
HLA-B27
Schober test
Assesses mobility of spine between 10cm above L5 and 5cm below
<20cm indicates a restri­ction
XR changes
Bamboo spine
Squaring of vertebral bodies
subcho­ndral sclerosis + eriosions
Syndes­mop­hytes
ossifi­cation
fusion of facet, SI and costov­ert­ebral joints
MRI
Bone marrow oedema
 

Image

Management

Medication
NSAIDs
Steroids in flares
Anti-TNF or monocl­onals (etane­rcept, inflix­imab)
Secuki­numab (against IL-17)
Other
Physio
Exercise
Avoid smoking
Bispho­sph­onates
Treat compli­cations
Surgery if deform­ities
 

Presen­tation

20 year old, gradual spinal stiffness over >3 months
Lower back pain + stiffness
Worse with rest/at night/in morning
Takes 30 minutes for pain to improve in morning
Experience flare ups
Vertebral fractures
Bamboo spine

Associ­ations

Systemic
Weight loss, fatigue
Chest pain
Enthesitis
Plantar fasciitis, achilles tendonitis
Dactylitis
Anaemia
Anterior uveitis
Aortitis
Heart block
Restri­ctive lung disease
Pulmonary fibrosis of upper lobes
IBD
 

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