Medical history (history of illness) is an important component in the diagnosis of ankylosing spondylitis. Family history Are there people in your family with back pain or bone/joint disease (eg, ankylosing spondylitis, reactive arthritis)? Social history What is your profession? Current medical history/systemic history (somatic and psychological complaints). Do you suffer from sensitivity to movement … Ankylosing Spondylitis: Medical History
Musculoskeletal system and connective tissue (M00-M99). Osteoarthritis Bacterial infection of the spine as in infectious spondylitis (“vertebral inflammation”). Nucleus pulposus prolapse (disc prolapse) – herniated disc. Degenerative spinal changes (eg, spondylosis). Diffuse idiopathic skeletal hyperostosis (DISH) – formation of excess bone tissue. Reiter’s disease (synonyms: Reiter’s syndrome, Reiter’s disease, urethro-oculo-synovial syndrome, arthritis dysenterica, post-enteritis reactive … Ankylosing Spondylitis: Or something else? Differential Diagnosis
The following are the most important diseases or complications that can be caused by ankylosing spondylitis: Eyes and eye appendages (H00-H59). Acute anterior uveitis/inflammation of the anterior segment of the eye (iridocyclitis/inflammation of the iris). Glaucoma (glaucoma) Cataract (cataract) Respiratory system (J00-J99) Pulmonary fibrosis – connective tissue remodeling of the lungs leading to functional limitation. … Ankylosing Spondylitis: Complications
Early diagnostic criteria of ankylosing spondylitis. Criteria Points Genetic factors HLA-B27 positive 1,5 Clinical factors Pain in the spine, sciatic area, heel pain. 1 Positive Mennell’s sign – jerky hyperextension of the extended leg of the patient, lying in prone or lateral position, in the sacroiliac joint (ISG). If pain is indicated, this is called … Ankylosing Spondylitis: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore: Inspection (viewing). Skin (normal: intact; abrasions/wounds, redness, hematomas (bruises), scars) and mucous membranes. Gait (fluid, limping). Body or joint posture (upright, bent, relieved posture) [hunchback formation; increased cervical … Ankylosing Spondylitis: Examination
1st order laboratory parameters – obligatory laboratory tests. Small blood count Differential blood count Inflammatory parameters – CRP (C-reactive protein) [↑ ; about 50% of cases] or ESR (erythrocyte sedimentation rate) [↑; normal ESR: about 20-30% of cases]. Detection of the HLA-B27 allele in the HLA-B gene [positive in 90-95% of cases]. Rheumatoid factor [negative] … Ankylosing Spondylitis: Test and Diagnosis
Therapy goals Improvement of the symptomatology or alleviation of rheumatic symptoms. Reduce the process of joint remodeling or delay the ossification of the spine. Therapy recommendations The recommended therapy presented below applies to ankylosing spondylitis (AS; synonyms: ankylosing spondylitis, ankylosing spondylitis) and to all forms of axial spondyloarthritis (axSpA) and, therefore, to nonradiographic axial spondyloarthritis … Ankylosing Spondylitis: Drug Therapy
Mandatory medical device diagnostics. Radiographic examination of the spine (pelvis or targeted imaging of the sacroiliac joints) – to examine bony changes in axial spondyloarthritis (axSpA) [gold standard in detecting chronic structural changes in patients with axial spondyloarthritis (axSpA) or suspected axSpA]. Magnetic resonance imaging (MRI; computer-assisted cross-sectional imaging (using magnetic fields, that is, without … Ankylosing Spondylitis: Diagnostic Tests
The surgical indication in ankylosing spondylitis is mainly in cases of severe inflammation of the hip joint. In this case, a total hip arthroplasty (hip TEP) is then used. In addition, spinal realignment may be necessary in selected affected individuals with extreme poor posture.
The following symptoms and complaints may indicate ankylosing spondylitis: Anorexia (loss of appetite). Sensitivity to movement of the spine Restricted breathing width (2 cm) at the level of the 4th intercostal space. Sensitivity to vibration of the spine Fever Weight loss Ischialgiform pain (or positive Mennell’s sign – when the patient’s extended leg is jerkily … Ankylosing Spondylitis: Symptoms, Complaints, Signs
Pathogenesis (disease development) Ankylosing spondylitis is a chronic inflammatory disease of the spine that is often associated with the presence of the laboratory parameter HLA-B27. The exact pathogenesis has not yet been fully elucidated. Immune-mediated reactions are assumed. In the course of the disease, erosions (defects) of the joints occur, which in turn are replaced … Ankylosing Spondylitis: Causes
General measures From the beginning of the diagnosis of the disease should be started with exercise therapy! Nicotine restriction (refraining from tobacco use) – smoking has an unfavorable effect on disease activity and also increases radiographic progression (progression of the disease). Nutritional medicine Nutritional counseling based on nutritional analysis Nutritional recommendations according to a mixed … Ankylosing Spondylitis: Therapy