Izni nur fatihah

Anatomy of the spine

Ankylosing spondylitis
form of chronic inflammation of the spine and the

sacroiliac joints. Chronic inflammation in these areas causes pain and stiffness in and around the spine. chronic inflammation of the spine (spondylitis) can lead to a complete cementing together (fusion) of the vertebrae, a process referred to as ankylosis. Ankylosis leads to loss of mobility of the spine.

Etiology
No specific causes
As a genitically (HLA-B27)determined

immunopathological disorder People who have gene HLA-B27 are at significantly increase risk of developing ankylosing spondylitis.

Risk factor
Sex: Males are affected more frequently than females
Age: between 15 and 25 years. Heredity: most people who have ankylosing

spondylitis have the HLA-B27 gene.

Pathology
Pathological changes proceed in three stages:
(1) an inflammatory reaction with cell infiltration,

granulation tissue formation and erosion of adjacent bone; (2) replacement of the granulation tissue by fibrous tissue; and (3) ossification of the fibrous tissue, leading to ankylosis of the joint.

CLINICAL FEATURES
backache and stiffness are worse in the early morning

and after inactivity. Referred pain in the buttocks and thighs pain and stiffness continuous general fatigue, pain and swelling of joints, tenderness at the insertion of the Achilles tendon, intercostal pain and tenderness

 Early on, slight flattening of the lower back and

limitation of extension in the lumbar spine. There may be diffuse tenderness over the spine and sacroiliac joints, or (occasionally) swelling and tenderness of a single large joint.

 A. Limited extension of the dorsal and cervical spine. B. and C. Straightening and rigidity of the lumbar spine when the

patient is asked to flex the trunk.

Extraskeletal manifestations
Iritis
uveatis

X-ray
Ankilosing spondylitis x-ray, an early sign is squaring of the lumbar vertebrae.

Ankylosing spondilytis- bony bridge (syndesmophytes) between the vertebral bodies convert the spine into a rigid column.

TREATMENT
educate the patient
general measures to maintain satisfactory posture and

preserve movement; anti-inflammatory drugs to counteract pain and stiffness; the use of TNF inhibitors for severe disease operations to correct deformity or restore mobility

COMPLICATIONS
Spinal fractures
Hyperkyphosis Spinal cord compression

Lumbosacral nerve root compression