Pages Below:
| |
Epidemiology
- 1:2000
- men (present earlier)6:1 at 16 years old, 2:1 at 30
- >95% +ve for HLA B27
- thought to follow certain infection i.e. Klebsiella
Pathology
- inflammation begins where spinal ligaments attached to vertebral bone
History
- late teenage, early 20s
- pain
- sacroiliac pain
- one or both buttocks
- low back pain
- morning stiffness
- arthritis
- assymetrical peripheral large joint
- progressive loss spinal movements
- development of kyphosis
- neck hyperextension
- spino-cranial ankylosis
- non-spinal complications
- Occasional unstable fractures after minor trauma
Examination
- thoracic excursion decreased
- chest pain
- hip / knee involvement
- periosteitis of calcaneum / ischial tuberosities
- plantar fasciitis
- amyloidosis
- carditis
- iritis
- lung fibrosis
Investigation
- X-rays
- bamboo spine
- squaring of vertebra
- erosion of apophyseal joints
- obliteration of sacro-iliac joints
- FBC
- ESR
Differential
- sacroiliitis also occurs in
Treatment
Mortality
|