Podcast
Questions and Answers
Ankylosing spondylitis has an onset age ranging from 30 to 50 years.
Ankylosing spondylitis has an onset age ranging from 30 to 50 years.
False (B)
The absence of syndesmophytes can be detected by MRI in the early stages of ankylosing spondylitis.
The absence of syndesmophytes can be detected by MRI in the early stages of ankylosing spondylitis.
True (A)
The term 'shiny corner' refers to anterior and posterior erosion of vertebral endplates called Romanus lesions.
The term 'shiny corner' refers to anterior and posterior erosion of vertebral endplates called Romanus lesions.
True (A)
Ankylosing spondylitis primarily affects the appendicular skeleton before the axial skeleton.
Ankylosing spondylitis primarily affects the appendicular skeleton before the axial skeleton.
Arachnoiditis is a common complication associated with ankylosing spondylitis.
Arachnoiditis is a common complication associated with ankylosing spondylitis.
Facets, costovertebral, and costotransverse joints are considered synovial joints affected by ankylosing spondylitis.
Facets, costovertebral, and costotransverse joints are considered synovial joints affected by ankylosing spondylitis.
Lung involvement in ankylosing spondylitis is predominantly characterized by lower lobe fibrosis.
Lung involvement in ankylosing spondylitis is predominantly characterized by lower lobe fibrosis.
Osteoporosis occurs commonly in the early stages of ankylosing spondylitis.
Osteoporosis occurs commonly in the early stages of ankylosing spondylitis.
Flashcards
What is 'Osteitis' in Ankylosing Spondylitis?
What is 'Osteitis' in Ankylosing Spondylitis?
Spinal inflammation in ankylosing spondylitis affecting the area where vertebral bones meet, leading to bone erosion and sclerosis. This is often seen in early stages and shows up on imaging as a 'Shiny Corner'.
What are Syndesmophytes?
What are Syndesmophytes?
Vertical bony growths on the vertebrae resulting from bone proliferation, a hallmark feature of Ankylosing Spondylitis.
What is Arachnoiditis?
What is Arachnoiditis?
A rare but serious complication of Ankylosing Spondylitis, involving inflammation of the arachnoid membrane which envelops the spinal cord. This can cause neurological symptoms.
What is 'Bamboo Spine'?
What is 'Bamboo Spine'?
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What is Enthesitis?
What is Enthesitis?
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What is Ankylosing Spondylitis (AS)?
What is Ankylosing Spondylitis (AS)?
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What is Anterior Uveitis?
What is Anterior Uveitis?
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What is Hip involvement in Ankylosing Spondylitis?
What is Hip involvement in Ankylosing Spondylitis?
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Study Notes
Ankylosing Spondylitis Overview
- A seronegative spondyloarthropathy, an inflammatory arthritis affecting sacroiliac joints and spine, leading to fusion (ankylosis).
- Typically onset 20-40 years, more common in males.
Axial Skeleton Involvement
- Initial changes often in SIJs (70-80%). Progression involves thoracolumbar and lumbosacral regions. Entire spine can be affected.
- MRI highly sensitive, detecting early inflammation (oedema).
- Spondylitis: Erosion of vertebral endplate corners (Romanus lesions) due to enthesitis (inflammation at attachment points). Progression to sclerosis ("shiny corner" osteitis).
- Discovertebral changes: Involvement of intervertebral discs and vertebral endplate centers (Andersson lesions).
- Syndesmophytes: Vertical bony growths from vertebral margins.
- Squaring of vertebrae: Bone proliferation.
- Synovitis: Affecting facet, costovertebral, and costotransverse joints; leading to erosion and ankylosis.
- Enthesitis: Inflammation at interspinous ligaments.
- Ankylosis: Fusion of spine, resulting in "bamboo spine".
- Insufficiency fractures: Common in ankylosed spine (e.g., cervicothoracic and thoracolumbar junctions).
- Osteoporosis: Frequent with long-standing disease.
- Kyphosis: Postural abnormality.
- Arachnoiditis: Rare, late complication, involving arachnoid diverticula, laminar erosions, and dural calcification.
Appendicular Skeleton Involvement
- Hip: Axial migration, joint space narrowing, osteophytes (bone spurs), acetabular protrusio; may cause dominant symptoms and flexion contractures.
- Shoulder: Glenohumeral and acromioclavicular joint narrowing, greater tuberosity erosion.
- Knee: Tricompartmental narrowing and erosion.
- Hands and feet: Asymmetrical involvement, small erosions, bone overgrowth.
Extraskeletal Manifestations
- Anterior uveitis: 20% prevalence, more common with peripheral arthropathy.
- Lungs: Upper lobe fibrosis, bullae (air-filled sacs), mimicking cavitating lesions. Also, nodules, pleural thickening, organising pneumonia and restrictive lung function due to costal joint involvement.
- Cardiovascular (CVS): Aortic valve insufficiency, arrhythmias, pericarditis, aortitis.
- Inflammatory bowel disease: Association
- Amyloidosis: Rare complication.
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Description
This quiz explores the key aspects of ankylosing spondylitis, a form of inflammatory arthritis primarily affecting the spine and sacroiliac joints. Understand the onset, progression, and specific skeletal changes associated with this condition, including MRI findings and related pathological features. Test your knowledge of its clinical manifestations and skeletal involvement.
