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Ankylosing Spondylitis презентация
Содержание
- 1. Ankylosing Spondylitis
- 3. Discovery 1890s Bechterew W. (1893). "Steifigkeit der
- 4. Description 20th century
- 5. Bone formation in AS
- 7. Spine
- 8. BASMI
- 10. Sacroiliac joints
- 11. Spine
- 16. Patient’s symptoms One half comes from inflammation, the second half comes from structural changes
- 17. Arthritis
- 19. Enthesopathy
- 22. Enthesopathy
- 24. Uveitis
- 25. Diarrhea
- 27. Aortitis
- 29. HLA B27 1970s HLA B27 + in
- 35. Non X-ray imaging Computed tomography Better comparing to X-rays But not validated and radiation-related
- 36. Non X-ray imaging of SIJ Bone
- 37. Non X-ray imaging of SIJ MRI 22 yo F with right LBP
- 38. Non X-ray imaging of SIJ MRI 16 yo M with 6 months LBP
- 39. Non X-ray imaging of SIJ MRI 33 yo M with Psoriasis & LBP
- 40. Spine - MRI
- 43. Prevalence of Axial SpA in US
- 44. Disease progression
- 45. Disease progression > in
- 46. Disease progression
- 49. TNF – iTNF 1990s-2000s
- 50. Efficacy of TNFi in AS
- 51. Other biologics: anti IL-17
- 52. Anti-TNF & NSAIDS
- 53. A ROYAL FAMILY of rheumatic diseases
- 54. Q1 A female with daily inflammatory low
- 55. Q2 HLA B27 is negative, and CRP
- 56. Q3 The MRI shows Enthesitis Bone marrow edema Capsulitis Erosion
- 57. Q4 MRI of sacroiliac joints is reported
- 58. Q5 Non-radiographic axial spondyloarthritis is
- 59. Q6 Recommended treatment will be NSAIDs Physical therapy TNF-alpha blockade Surgery
- 60. The great A case from 1200s BC
- 61. The great A case from 1200s BC
- 62. DISH vs AS
- 63. Psoriatic arthropathy
- 64. Psoriatic arthropathy
- 67. Psoriasis
- 68. Enthesopathy
- 69. Uveitis
- 71. Treatment
- 74. Reactive arthritis
Discovery
1890s Bechterew W. (1893). "Steifigkeit der Wirbelsaule und ihre Verkrummung als besondere Erkrankungsform". Neurol Centralbl 12: 426–434 Strumpell A. (1897). "Bemerkung uber die chronische ankylosirende Entzundung der Wirbelsaule
Слайд 3Discovery
1890s
Bechterew W. (1893). "Steifigkeit der Wirbelsaule und ihre Verkrummung als besondere
Erkrankungsform".
Neurol Centralbl 12: 426–434
Neurol Centralbl 12: 426–434
Strumpell A. (1897). "Bemerkung uber die chronische ankylosirende Entzundung der Wirbelsaule und der Huftgelenke". Dtsch Z Nervenheilkd 11 (3–4): 338–342
Marie P. (1898). "Sur la spondylose rhizomelique". Rev Med 18: 285–315.
Слайд 16Patient’s symptoms
One half comes from inflammation,
the second half comes from
structural changes
Слайд 29HLA B27
1970s
HLA B27 + in 90% of Caucasian AS pt
Only 5%
of HLA B27+ persons will have AS
HLA B27 represents only about 25% of ‘genetic risk’ for AS
HLA B27 represents only about 25% of ‘genetic risk’ for AS
Слайд 35Non X-ray imaging
Computed tomography
Better comparing to X-rays
But not validated and
radiation-related
Слайд 43Prevalence of Axial SpA
in US (NHANES study)
chronic back pain in 20%
of population
IBP in 7% of population; > in younger adults
AxSpA (including AS) in 1.4%
AS in 0.5%
IBP in 7% of population; > in younger adults
AxSpA (including AS) in 1.4%
AS in 0.5%
AS
nrAxSpA
12%
in
2 years
MALES=FEMALES (AxSpA); M:F=2:1 (AS)
Слайд 45Disease progression
> in males
> in smokers
> in those with high CRP
>>>
in those with syndesmophytes at baseline
Слайд 54Q1
A female with daily inflammatory low back pain during the last
two years presents for evaluation. You do not find anything wrong on her examination. Your next step will be to order everything but
HLA B27
X-ray of her pelvis
MRI of her pelvis
C-reactive protein
HLA B27
X-ray of her pelvis
MRI of her pelvis
C-reactive protein
Слайд 55Q2
HLA B27 is negative, and CRP is normal. Pelvis X-rays are
normal as well. Your next step will be
MRI of sacroiliac joints
Technetium bone scan
Computed tomography of the whole spine
Follow up after 6 months
MRI of sacroiliac joints
Technetium bone scan
Computed tomography of the whole spine
Follow up after 6 months
Слайд 57Q4
MRI of sacroiliac joints is reported as abnormal, with bone marrow
edema around SIJ on both sides. The diagnosis is
Non specific low back pain
Ankylosing spondylitis
Undifferentiated spondyloarthritis
Non-radiographic axial spondyloarthritis
Non specific low back pain
Ankylosing spondylitis
Undifferentiated spondyloarthritis
Non-radiographic axial spondyloarthritis
Слайд 58Q5
Non-radiographic axial spondyloarthritis is
An early phase of ankylosing spondylitis
A variant
of osteitis condensanse ilii
A new name for DISH
A variant of reactive arthritis
A new name for DISH
A variant of reactive arthritis
