https://idwiki.org/index.php?action=history&feed=atom&title=Ankylosing_spondylitis 2026-05-13T00:01:20Z Revision history for this page on the wiki MediaWiki 1.43.8 https://idwiki.org/index.php?title=Ankylosing_spondylitis&diff=4932&oldid=prev 2020-07-14T23:43:29Z

<p>Text replacement - &quot;Clinical Presentation&quot; to &quot;Clinical Manifestations&quot;</p> <table style="background-color: #fff; color: #202122;" data-mw="interface"> <col class="diff-marker" /> <col class="diff-content" /> <col class="diff-marker" /> <col class="diff-content" /> <tr class="diff-title" lang="en"> <td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Older revision</td> <td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 23:43, 14 July 2020</td> </tr><tr> <td colspan="2" class="diff-lineno">Line 33:</td> <td colspan="2" class="diff-lineno">Line 33:</td> </tr> <tr> <td class="diff-marker"></td> <td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>**** Psoriasis</div></td> <td class="diff-marker"></td> <td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>**** Psoriasis</div></td> </tr> <tr> <td class="diff-marker"></td> <td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br /></td> <td class="diff-marker"></td> <td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br /></td> </tr> <tr> <td class="diff-marker" data-marker="−"></td> <td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>== Clinical <del style="font-weight: bold; text-decoration: none;">Presentation</del> ==</div></td> <td class="diff-marker" data-marker="+"></td> <td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>== Clinical <ins style="font-weight: bold; text-decoration: none;">Manifestations</ins> ==</div></td> </tr> <tr> <td class="diff-marker"></td> <td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br /></td> <td class="diff-marker"></td> <td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br /></td> </tr> <tr> <td class="diff-marker"></td> <td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* Ache and tenderness of lumbar or gluteal regions</div></td> <td class="diff-marker"></td> <td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* Ache and tenderness of lumbar or gluteal regions</div></td> </tr> <!-- diff cache key site7_mediawiki:diff:1.41:old-4088:rev-4932:wikidiff2=table:1.13.0:bc2a06be --> </table>

Aidan https://idwiki.org/index.php?title=Ankylosing_spondylitis&diff=4088&oldid=prev 2020-07-04T01:17:23Z

<p>Imported from text file</p> <p><b>New page</b></p><div>== Definition ==<br /> <br /> * An axial seronegative spondyloarthritis characterized by sacroiliitis and progressive spinal disease<br /> <br /> == Risk Factors ==<br /> <br /> * Age 20s to 30s<br /> * Male to female ratio of 2:1 to 3:1<br /> <br /> == Diagnostic Criteria (ASAS) ==<br /> <br /> * ≥3 months of back pain, and<br /> * Onset ≤45 years, and<br /> * Either of:<br /> ** Sacroiliitis on imaging and 1 or more features of spondyloarthritis<br /> ** HLA-B27 positive and 2 or more features of spondyloarthritis<br /> * Where<br /> ** Sacroiliitis on imaging means either:<br /> *** Definite evidence based on modeified NY criteria<br /> *** Active inflammation on MRI<br /> ** Spondyloarthritis features are:<br /> *** Inflammatory back pain<br /> *** Response to NSAIDs<br /> *** Family history of spondyloarthritis<br /> *** HLA-B27 positive<br /> *** Elevated CRP<br /> *** Extra-spinal manifestations<br /> **** Arthritis<br /> **** Enthesitis<br /> **** Uveitis<br /> **** Dactylitis<br /> **** Inflammatory bowel disease<br /> **** Psoriasis<br /> <br /> == Clinical Presentation ==<br /> <br /> * Ache and tenderness of lumbar or gluteal regions<br /> * Hip arthritis in 30%, shoulder arthritis in less<br /> * Bony tenderness of costosternal junctions, spinous processes, iliac crests, greater trochan- ters, ischial tuberosities, tibial tubercles, and heels<br /> * Peripheral arthritis in 30% of patients, usually asymmetric<br /> * Sequelae<br /> ** Acute anterior uveitis in 40%<br /> *** Unilateral painful, teary eye with photophobia<br /> ** Aortic insufficiency (early)<br /> ** Third-degree heart block<br /> ** Cauda equina syndrome and upper pulmonary lobe fibrosis (rare, late)<br /> ** Retroperitoneal fibrosis (rare)<br /> <br /> === Physical exam ===<br /> <br /> * Modified Schober test<br /> ** Marks made on the spine at lumbosacral junction (line between the PSISs) and 10 cm above<br /> ** Maximal forward flexion with knees straight<br /> ** Normal ≥5cm, restricted &amp;lt;4cm<br /> <br /> === BASDAI ===<br /> <br /> * Disease activity measure<br /> <br /> == Investigations ==<br /> <br /> * Labs<br /> ** HLA-B27 helpful but neither sufficient nor necessary<br /> *** 90% of ank spon patients have HLA-B27<br /> ** CRP, elevated<br /> * Imaging<br /> ** X-ray of the SI joints<br /> ** If x-ray negative but suspicion high, consider MRI<br /> <br /> == Management ==<br /> <br /> * All patients should participate in active, land-based physical therapy<br /> * First-line: NSAIDs for a two-week trial<br /> ** Naproxen 500mg PO BID<br /> ** Meloxicam 7.5mg PO BID<br /> * Second-line, if fails two NSAIDs: biologics<br /> ** Specifically, TNF-alpha inhibitors<br /> ** Etanercept<br /> * DMARDs &#039;&#039;NOT&#039;&#039; helpful (i.e. methotrexate, sulfasalazine)<br /> <br /> [[Category:Rheumatology]]</div>

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