Ankylosing spondylitis

4.9
(8)

Introduction:

  • Axial dominant spondyloarthropathy
  • Males are more commonly affected
  • HLA-B27 positive
  • Family history often present
  • Primary site: Enthesis (junction of bone & tendon)
  • MC site involved: B/L sacroilitis.

Stages:

  1. Enthesitis
  2. Marrow edema (Reversible)
  3. Marginal syndesmophyte
  4. Ankylosis (fusion of vertebral bodies).

Radiology:

  • IOC is MRI (to detect sacroilitis early)
  • X-ray features:
    1. Squaring of vertebral body:
    2. Romanus/ Shiny corner sign:
    3. Andersson lesion (Central erosion of vertebral endplate):
    4. Dagger sign (fusion of inter-spinous ligaments):
    5. Bamboo spine (Outermost fibres of annulus fibrosus are ossified):

Rx: Consider early use of DMARDs & Biological agents.

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