Ankylosing spondylitis,Causes,symptoms,diagnosis,management

Presented by MD.Monsur Rahman
MPT (Musculoskeletal Disorders)
MM INSTITUTE OF PHYSIOTHERAPY & REHABILITATION
MM UNIVERSITY, MULLANA, AMBALA

1. Presented By MD. MONSUR RAHMAN MM INSTITUTE OF PHYSIOTHERAPY & REHABILITATION MULLANA , AMBALA MPT ( Musculoskeletal Disorders) Ankylosing Spondylitis

2. Ankylosing Spondylitis Ankylosing spondylitis is a form of arthritis that mainly affects the spine and sacroiliac joints, or the lower back Ankylosing spondylitis can be difficult to diagnose but has a particular pattern of pain symptoms, and changes can be seen on X-ray and  MRI

3. Pain In The Lower Back, Hips, And Buttocks Stiffness In The Lower Back, Hips, And Buttocks Neck Pain Ligament And Tendon Pain Tiredness Night Sweats Mild  Fever Appetite Loss General Discomfort Early signs and symptoms

4. At this stage, signs and symptoms include pain, stiffness, and tenderness on both sides of the body These symptoms often spread to other body parts . AS can eventually lead to changes in posture Tiredness, caused by the body's reaction to  inflammation , is another common long-term symptom. Signs and symptoms over time

5. The Spine Neck Ribs Shoulder Joints Hips Thighs Joints Of The Hands Joints Of The Feet Areas most commonly affected

6. Causes The cause of AS is unknown . People with the HLA-B27 gene are at greater risk of developing the condition Risk factors : Age ( 15 to 40) Sex(Approximately  Three Times More  men than women) Genetics And Family History

7. Physical examination Diagnostic criteria include: Inflammatory back pain:Chronic , inflammatory back pain is defined when at least four out of five of the following parameters are present: (1) Age of onset below 40 years old, (2) insidious onset, (3) improvement with exercise, (4) no improvement with rest, and (5) pain at night (with improvement upon getting up) Past history of inflammation in the joints, heels, or tendon-bone attachments Family history for axial spondyloarthritis Diagnosis

8. Positive for the  biomarker   HLA-B27 Good response to treatment with  nonsteroidal anti-inflammatory drugs  (NSAIDs) Signs of elevated inflammation ( C-reactive protein  and  erythrocyte sedimentation rate ) Manifestation of  psoriasis ,  inflammatory bowel disease , or inflammation of the eye ( uveitis ) If these criteria still do not give a compelling diagnosis  magnetic resonance imaging  (MRI) may be useful

9. Blood tests Doctors may also request blood tests to detect the presence of the HLA-B27 gene. This gene is present in up to 95%  of white people in central Europe and North America who have AS. However, not everyone with the gene goes on to develop AS. Only 1 to 2 percent of people with the HLA-B27 gene are affected by the condition.

10. Imaging Tests X-rays may be performed on the spine to see if the joints are damaged or fused May order a   MRI scan  if nothing shows up on the X-ray. MRI scan detect inflammation without joint damage.

11. Physical Therapies And Exercises Advice Drugs Surgery, In Rare Cases Treatment

12. Early intervention with physical and occupational therapy is important to maintain function and minimize deformity. Exercise programme.  A program of daily exercise helps reduce stiffness, strengthen the muscles around the joints and prevent or minimize the risk of disability. Deep breathing exercises may help keep the chest cage flexible. Swimming  is an excellent form of  exercise for people with ankylosing spondylitis. Physical and Occupational Therapy.  

13. Moderate-to-high impact exercises like  jogging  are generally not recommended or recommended with restrictions due to the jarring of affected vertebrae that can worsen pain and stiffness in some with AS Exercise programs, either at home or supervised Group exercises Proprioceptive neuromuscular facilitation (PNF) Electro therapy: Transcutaneous electrical nerve stimulation(TENS) Hot Compression

14. The main drugs used to ease the pain and inflammation of AS are nonsteroidal anti-inflammatory drugs ( NSAIDs ). Examples include ibuprofen, naproxen, and diclofenac . Acetaminophen and codeine are also options if NSAIDs are unsuitable or insufficient. Drug Treatment

15. Locally injected corticosteroids Disease-modifying anti-rheumatic drugs ( dmards ), such as sulfasalazine (brand names: azulfidine or sulfazine ) and methotrexate ( otrexup , rheumatrex , or trexall ) Tumor  necrosis factor (TNF) antagonists, such as  adalimumab  ( humira ), certolizumab ( cimzia ),  etanercept  ( enbrel ), golimumab ( simponi ), or  infliximab  ( remicade ) Other biologic treatments, such as secukinumab ( cosentyx ) Other Drug Options Include:

16.  Artificial joint replacement surgery may be a treatment option for some people with advanced joint disease affecting the  hips  or  knees . Surgery

17. Thank You