Reading Time:
Pathology
Enthesitis with chronic inflammation, including cytokines particularly tumor necrosis factor-α leading to fibrosis and ossification at sites of enthesitis
Aetiology
Strong association with HLA-B27
Signs
Signs: Tenderness of the Sacro-Iliac joint or a limited spinal ROM.
Kyphosis- Schober’s test is used to assess for limited spinal range of movement
Lung fibrosis, Achilles tendonitis, anterior uveitis, aortic regurgitation, anaemia, amyloidosis
Symptoms
Lower back pain, morning joint stiffness, malaise, sacroiliitis causing buttock pain
Investigations
Bloods: FBC, ESR, CRP and HLA-B27
Imaging: X-rays show sacroiliitis, syndesmophyte formation, vertebral fusion
(bamboo spine), marginal erosion
Treatment
Conservative: Physiotherapy
Medical: Long term NSAIDs, DMARDs and Biological Therapy
Surgical: Osteotomy for kyphosis
Prognosis
Increased mortality compared to general population
Amyloidosis, respiratory complications due to immobility of spine
Key Facts
Lorem ipsum dolor sit amet, sapien platea morbi dolor lacus nunc, nunc ullamcorper. Felis aliquet egestas vitae, nibh ante quis quis dolor sed mauris.
Key Images
Lorem ipsum dolor sit amet, sapien platea morbi dolor lacus nunc, nunc ullamcorper. Felis aliquet egestas vitae, nibh ante quis quis dolor sed mauris.
Key References
Lorem ipsum dolor sit amet, sapien platea morbi dolor lacus nunc, nunc ullamcorper. Felis aliquet egestas vitae, nibh ante quis quis dolor sed mauris.