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ANKYLOSING SPONDYLITIS
Treatment Guideline Chart
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.

Surgical Intervention

  • Collaboration with orthopedic surgeon to consider the following:
    • Total hip arthroplasty in ankylosing spondylitis (AS) patients with refractory pain/disability, structural damage as seen in radiographs
    • Spinal corrective osteotomy in AS patients with severe disabling deformity (eg severe kyphosis)
  • Recommend consultation with spinal surgeon in AS patients with acute vertebral fracture
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