ANKYLOSING SPONDYLITIS

ARTHRITIS
 Definition
Previously known as bekterev disease
Is a chronic inflammatory arthritis and
autoimmune disease
It mainly affect the joint in the spine
and the sacroilium in the pelvis
 Risk Factor
Man are commonly affected than
women
65% on twin
33% on person with B27
Correlation with bowel disease with
viral contact
 Sign and Symptom
20-40 year of age ‘’ chronic pain ‘’
Stiffness on the lower part of abdomen
Pain on the buttock area, thigh from
the sacroilliac joint
Subchondral marrow edema
Synovitis
Erosion of the illiac cartilage
Classical sign is the BAMBOO SPINE
Bamboo Spine
 Diagnostic Procedure
X-ray
Magnetic Resonance Imaging Scan

Laboratory finding
No specific laboratory finding
Presence of HLA-B27 gene
Elevated ESR
Pathogenesis/Disease Progression

Multiple cause Exposure to viral antigen

Twin
Person with gene B27
Older person
20-40 year old exposure
on viral contact Initiate inflammatory
response
(response to antigen)

Continuous deposition
and presence inside the Antigen-Antibody
body system DEPOSITION of immune
complexes
 Result in chronic  Destruction of cartilage
inflammation  Rounding of joint
connection

Prolong presence of
immune complex

Synovial joint Decrease of synovial fluid

affection  hypertrophy and
Interconnection thickening of muscle around
affection area

Chronic inflammation, pain, occlusion PAIN

 Decrease blood PANNUS
supply Vascular granulation tissue
(pannus occur) that form in synovial membrane
of client

Pannus gradually
extend

Invade joint capsule Causing bone

and subcondral destruction
bone (reforming)

Occlusion on area lead to forming of unorganized figure

BAMBOO SPINE
SPINE AFFECTION
 Treatment
No cure is known for AS
Symptomatic relief
Physical therapy and exercise
Walking aid
 Medication
Pain relieving drugs
TNF blocker (immuno
suppressant) AS
 Surgery
indicated for severe and major
complication

Joint replacement (knee, hip)

Surgical correction (flexion difficulties)
Spine curvature risky
Changes in upper airway
INTUBATING NEEDED
 Physical Therapy
Swimming
Slow movement
Stretching
Yoga
Climbing
Activities (depending on severity)