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Ankylosing Spondylitis (95-97% have HLA B27)

CNS Infections>

Mind Map branch: Ankylosing Spondylitis (95-97% have HLA B27) Ankylosing Spondylitis (95-97% have HLA B27) Syndesmophyte Inflammation @ Enthesis Ossification Outer Layers of Annulus Fibrosus Cannot revert back Ossification Bony Bridge between 2 Adjacent Vertebra NO ROM (range of motion) Adjustment = Fracture = Death Doesn't Pertain to Bony Spurs Chest Expansion Rib joint Ossification (limits expansion) Measure circumference @ nipple line (4th intercostal) In full Inspiration In full Expiration Difference between full inspiration and full expiration Not less then 6cm Less then 3cm = Ankylosis Spondylitis (Aka NY Criteria) Diaphragmatic breathing only Charateristics Pain in Low Back or Butt Young Males Male 4:1 Female Pain in Spine much Stronger During 2nd half Night or early Morning Mildest during evening (cause of more movement) Motion = Decrease in Pain Exercise = Beneficial Leads to decrease of pain Prevents Joint Ankylosis Disuse Osteoporosis (DUE TO LACK OF MOTION) Chiropractic 2ndry treatment after inflammation is treated Improves motion Complications Iritis (Aka Iridocyclitis) Inflammation of Iris IMPORTANT DIAGNOSTIC SIGN OF AS Adhesion of Iris to Pupil Part of NY Criteria for AS Causes Eye Pain Only Impacts Accommodation Develops before it manifests in the spine (10-15yrs later) Aortic Insufficiency Dilation of Aortic Ring with vascular insufficiency Causes Rheumatic Fever Bacterial Endocarditis Tertiary Syphilis Sign (No DIASTOLIC PRESSURE) Morbidity = 0.1-0.5% Ossification all Ligaments Flexion Lmtd Lateral Flexion Lmtd Loss of ROM (Advanced) Kyphosis Flattened Bent Knees for stability Early stages Sacroiliitis

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(Aka Idiopathic ankylosing Spondylitis, Marie-Strumpell-Bechterew's Disease)
Should be Bech1892-Strump 1897-Marie 1898
Bamboo Spine = Later Stages
Trolly Track sign on XRAY = Fusion of Joints AS Starts from Bottom of Spine & moves Up = Psoriatic Spondylitis, Reiter's Syndrome, Irritable bowel disease = Begins anywhere with Sporadic manifestations

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