Spondylitis ppt for learning purposes.

1. Dr Md Shamshir Alam, PhD
Associate Professor
MM College of Pharmacy
Mullana-Ambala, India

2. • Previously known as Bechterews disease, OR, Bechterews
syndrome OR, Marie Strumpell.
• Spondylitis means inflammation in the spinal bones,
or vertebrae.
Introduction

3. • Spondylitis is a term that refers to a set of chronic arthritis-like
disorders that affect the spine and sacroiliac joints.
• Spondylitis is an autoimmune disease in which the immune system
assaults the joints, resulting in inflammation, bone fusion, and
excessive bone growth.
• It affects the spine's joints as well as the sacroiliac joint in the
pelvis, resulting in spine fusion
• Joint inflammation can cause bones to fuse together and generate
excessive bone growth in the spine. Excessive curvature of the
spine can occur in severe situations.

4. • Complete fusion results in a complete rigidity of the spine ,
this condition is called as bamboo spine.
• Generally Spondylitis involves younger group of people,
aged 18-30 years.
• Men are affected more than women at a ratio of 3:1

5. Spondylitis: Traditional classification
1. Ankylosing spondylitis
2. Reactive arthritis
3. Psoriatic arthritis
4. Enteropathic Arthritis
5. Juvenile spondyloarthritis
6. Undifferentiated spondyloarthritis

6. • The cause of spondylitis is unknown, but a tendency to
develop the condition maybe genetic.
Causes of spondylitis

7. Signs and Symptoms
• Mild to severe back and buttock pain that often worsen in the early
morning hours.
• This pain usually gets better with activity.
• There is continued inflammation of the:
• Ligaments
• Tendons
• Joint capsules (soft tissues surrounding the joint)
• And the joint of the spine

8. • Cause the spine to fuse together together a the joints and disc spaces
are replaced by bone leading to decreased motion in the neck and low
back.
• As the spine fuses or stiffens
- the neck and the low back lose their normal curve,
- the mid-back curves outward
- and a fixed bend– forward position can result
- leading to significant disability

9. • Inflammation of the small joints joining the ribs and collarbone to the
breastbone
- cause less expansion of the chest wall with breathing.
Another common symptom is generalized fatigue.

10. Diagnosis
• There is no specific test to diagnose spondylitis.
• Blood test is done for the detection of HLA-B27 gene.
• X-ray show characteristic spinal changes.
• Tomography and magnetic resonance imaging of the sacroiliac joints
but the reliability of tests is still unclear.
• Schobers test– a useful clinical measure of flexion of the lumber spine
performed during examination.

11. • There is no cure for spondylitis but medication and exercise can ease
pain and help keep the back strong.
• Treatments and medications are available to reduce symptoms and pain
.
Treatment

12. Medication therapy
There are three major types of medications used for spondylitis:
ANTI-INFLAMMATORY DRUGS
• Includes NSAIDs such as aspirin, ibuprofen, phenylbutazone,
indomethacin, naproxen, and COX-2 inhibitors which reduce
inflammation and consequently pain.
DMARDs (Disease modifying antirheumatic drugs)
• Such as cyclosporin, methotrexate, sulfasalazine, and corticosteroids
• Reduce the immune system response through immunosuppression
effects.

13. Anti-tumor necrosis factor (TNF) medication
• Drugs like etanercept, infliximab and adalimumab (also known as
biologics).
• Indicated for the treatment and are effected immunosuppressants and
in other autoimmune disease.
• It has also been shown to be most promising treatment ,slowing the
progress of spondylitis in the majority of clinical cases.
• They have been shown to be highly effective in treating not only the
arthritis of the joints but also the spinal arthritis associated with
spondylitis.

14. Physical therapy
• To increase and maintain spine flexibility, physical therapy may
include massage and spinal manipulation.
• Exercise to relieve joint stiffness and pain.
• Exercising the lungs to ensure proper chest expansion

15. Surgical Management
• May include osteotomy for marked deformities of the hip/spine.
• In this a section of spinal bone is cut and removed to allow for
correction of spinal alignment.
• Occasionally, hip or knee arthroplasty is used, if there is severe
arthritis of those joints.