Inflammatory disorder of unknown cause that primarily affects the axial skeleton and peripheral joints

2. DEFINITION
 Inflammatory disorder of unknown cause that primarily
affects the axial skeleton and peripheral joints
 It is a autoimmune disorder

3. CAUSES
1) Idiopathic
2) Rheumatoid factor absent
3) HLA-B27 present in > 90% cases

4. CLINICAL FEATURES
 EARLY SYMPTOMS-
1)Insidious onset with dull pain in the lower
lumbar or gluteal region.
2)Morning stiffness in low back for few hours that
is relieved with activity.
3)After sometime, continuous back pain or
stiffness.
4)Bony tenderness may present at- costosternal
junctions, spinous processes, iliac crests, ischial
tuberosities, tibial tubercles, and heels.
5)Neck pain and stiffness from involvement of the
cervical spine

5.  LATE SYMPTOMS
1)Arthritis in the hips and shoulders joints .
2)Continuous Pain.
3) In a typical severe untreated case- the
patients posture undergoes characteristic
changes
lumbar lordosis

6. buttock atrophy
forward stoop of the neck
thoracic kyphosis

7.  COMPLICATION of the spinal disease is
spinal fracture (even with minor trauma)
 LAB. TESTS
1)HLA B27 is present in ≈ 90% of patients
2)ESR and CRP – often elevated
3) Elevated serum IgA levels.
4)Alkaline phosphatase (ALP) & Creatine
Phosphokinase (CPK) raised.
5)X-RAY and MRI shows Sacroiliitis-it is a condition in
which one or more sacro-iliac joints are inflammed.

8. 6) Lumbar spine:
 straightening
 osteoporosis
 Bamboo spine appearance
(fusion of vertebral margins)