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ANKYLOSING SPONDYLITIS
Spondyloarthritis refers to a group of inflammatory diseases characterized by spinal & joint oligoarthritis, enthesitis, and sometimes mucocutaneous, ocular and/or cardiac manifestations.
Ankylosing spondylitis is a prototype of spondyloarthritis, particularly of the axial form.
Diagnosis of ankylosing spondylitis is definite if any of the radiological criterion (grade≥2 bilateral sacroiliitis or grade ≥3 unilateral sacroiliitis) is associated with at least one of the clinical criterion (low back pain & stiffness for >3 months that improves with exercise but not relieved by rest, limitation of motion of the lumbar spine in the sagittal and frontal planes, limitation of chest expansion relative to normal values correlated for age and gender.

Introduction

  • Spondyloarthritis (SPA) refers to a group of inflammatory diseases characterized by spinal and joint oligoarthritis, enthesitis, and sometimes, mucocutaneous, ocular, and/or cardiac manifestations 

Definition

  • Ankylosing spondylitis (AS) is a prototype of spondyloarthritis (SPA), particularly of the axial form of spondyloarthritis (SPA)

Signs and Symptoms

Main Clinical Manifestations

  • Inflammatory back pain (IBP) or chronic back pain persisting for >3 months, confirmed by 4 of the following:
    • Onset before 40 years of age
    • Insidious onset
    • Improves with exercise
    • Nocturnal pain with improvement upon getting up
    • Associated with morning stiffness not improved by rest
  • Inflammation of the attachments of ligaments and tendons to bones (enthesitis)
  • Peripheral arthritis
  • Ankylosis
  • Dactylitis
  • Anterior uveitis

Clinical Manifestations of Ankylosing Spondylitis

  • Inflammatory back pain (IBP)
  • Chest pain/costochondritis
  • Alternate buttock pain
  • Acute anterior uveitis
  • Synovitis predominantly of lower limbs, asymmetric
  • Enthesitis (eg heel, plantar)
  • Radiographic sacroiliitis
  • Positive family history of ankylosing spondylitis (AS), chronic inflammatory bowel disease (IBD) or psoriasis
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07 Mar 2018
The use of trabecular bone score (TBS) may be helpful in evaluating osteoporosis in ankylosing spondylitis (AS), as it is associated with the erythrocyte sedimentation rate (ESR) and severity of sacroiliitis in young male patients with AS, suggests a recent study.