Wednesday, 18 February 2009

about ankylosing spondylitis

chronic inflammatory disorder of the axial skeleton.
strong genetic predisposition associated with HLA B27.
incidious nature,characerized by:
inflammation of entheses,
formation of syndesmophytes.

traditional treatment begins with physiotherapy,regular use of NSAID's,local corticosteroids injections and sometimes sulphsalazine.

surgery has a place in manaement including fusion procedures or wedge lumber osteotomy.

TNF inhibitors has revolutionized the management of AS.
three drugs are currently available:
etanercept,infleximab and adalimumab.
treatment with TNF inhibitors should be considered for patients with persistantly high disease activity despite conventional tratments.

Question:AS is easy to spot in the exam.what are the steps of examination to score 4/4? what question you might want to ask the patient?


  1. ask aboui back pain and morning stiffness that ges better in the afternoon
    ask about other joint pains
    ask about eye diease
    ask abour plantar fasicitis
    ask about SOB cardiac and apical fibrosis
    ask about hernias
    u know the A disease presentation!!

  2. things do in examination

    inspect for the S shape spine
    do the occipti to heal test
    look for the A signs
    assess back movements
    assess S JOINT function