Disorders




(2)
Department of Orthopaedics, Denver Health Medical Center, 777 Bannock Street, Denver, 80204, CO, USA

 



Take-Home Message





  • Inflammatory enthesopathy, facet inflammation


  • Related to HLA-B27 antigen, males more often than females


  • Causes bamboo spine appearance


  • Involves SI joints


  • Osteoarthritis of the hips


Definition





  • Enthesis – where the tendon, muscle, or ligament attaches to bone.


  • Ankylosing spondylitis is an inflammatory disorder where the anterior longitudinal ligament attaches to bone.


Etiology





  • Autoimmune phenomenon


  • Associated with HLA-B27 antigen


Pathophysiology





  • Enthesitis of discs and facets.


  • Syndesmophytes are marginal.


  • SI joints involved.


  • Other organ systems involved.


  • Causes kyphosis especially the cervicothoracic junction.


  • Fractures can occur with little trauma.


Radiographs





  • X-rays: Marginal syndesmophytes


  • CT: Bony definition in case of fracture


  • MRI: Can identify occult fracture


  • Nuclear medicine to look for occult fracture and SI inflammation


Classification

None


Treatment

Nonoperative



  • NSAIDs.


  • DMARDs: TNF-alpha-blockers.


  • Postural and flexibility exercises.


  • Treat bone density.

Operative

Tags:
Sep 18, 2016 | Posted by in ORTHOPEDIC | Comments Off on Disorders

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