Write about Ankylosing Spondylitis here.
• Typically a young man who presents with lower back pain and stiffness, or with asymmetrical large joint arthritis
• M:F = 8:1
• HLA-B27 (90-95%)
• Familial tendency - 1/4 relatives affected
• Usually presents before 45
• Stiffness usually worse in the morning and improves with activity
• Peripheral arthritis (25%, more common in females)
Other Features - The 'A's:
• Apical fibrosis
• Anterior uveitis
• Aortic regurgitation
• Achilles Tendonitis
• AV node block
• And cauda equina syndrome
• Heel, hips and occiput - can put all against wall?
• Schober's Test
• mark a point at level of posterior iliac spines (dimples of Venus) and a point 10cm above (or 5cm below and 5cm above).
• Then patient to bend forward
• The increase in distance should be 8-10cm (<3 is very reduced)
• Then repeat at thoracic T1 and 20cm lower - increase should be 8cm.
• If not achieved - ank spond
• Sacroilitis - subchondral erosions, sclerosis
• Squaring of lumbar vertebrae
• 'bamboo spine' (late and uncommon)