AS Exam

Question 1

Hx 1- FAGI

Answer 1

• Familial history
• Age: Maximum incidence: 15-30 years
• Gender: Male (3) : female (1)
• Insidious onset of:
  Lower backache (lumbar area most commonly affected) (worse at night, in the morning, or after inactivity)
  Joint stiffness (e.g. lumbar, hip)
  Fatigue (due to the inflammation)
• Clinical course characterised by variable pattern of active phases interspersed with remissions.
• Women often present atypically

Question 2

Early Manifestations

Answer 2

* Pain
unilateral
dull, diffuse
Lx spine & SIJs (d/t inflammation)
1/4 of Pts have hip / Knee / shoulder involvement (enthesitis)
* Decreased ROM
* Joint stiffness (gelling) post-inactivity
* Tenderness: Lx Spine and SIJs
* Systemic:
fever
discomfort
decr. appetite

Question 3

Established Manifestations

Answer 3

• Pain & Stiffness affects other areas
• bilateral progression (SIJs)
• ascending pattern in spine
• shoulders / knees / ankles
• heel pain (d/t enthesitis)
• neck pain
• SSx of Paraspinal ST Ossification
• stooped posture (vert fusion)
• decr. Lx Lordosis
• incr. Tx kyphosis
• decr. Tx cage motion
• forward thrust neck

Question 4

Extra-articular Manifestations

Answer 4

• anterior uveitis (iritis) (red eyes, visual disturbance)
• aortic incompetence (in long standing disease)
• IBD (Crohn’s and UC)
• respiratory disease
• apical fibrocystic Dz
• neurological manifestations
• d/t: compression radiculitis, vertebral fracture, vertebral subluxation etc)

Question 5

Systemic Manifestations

Answer 5

• malaise
• fever (low grade)
• fatigue
• anorexia
• LoW
• anaemia (pallor)