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Last updated: 2017-08-09 17:38
Spondylitis
Spondylitides
Spondylitis is an inflammation of the vertebra.
Presentation
- CASE PRESENTATION: A 33-year-old woman presented with fever, chills, and acute episodes of low back pain. The sole unusual finding was pain upon spinal percussion, limited to the 4th and 5th lumbar vertebrae. Spinal MRI showed no abnormality.[ncbi.nlm.nih.gov]
- The patient presented in advanced stage with progressive severe neurological symptoms due to spinal cord compression. Non-enhanced magnetic resonance imaging led to misdiagnosis of the lesion as a neoplastic process.[ncbi.nlm.nih.gov]
- CASE PRESENTATION: A 13-year-old boy presented with occasional high fever and lower back pain. He was diagnosed with spondylitis of the L4-5 vertebral bodies and paravertebral abscess.[ncbi.nlm.nih.gov]
- The infection could be a result of diabetic neuropathy, presenting neurogenic bladder and hydronephrosis.[ncbi.nlm.nih.gov]
- […] spontaneous pain or tenderness at examination of an enthesis Uveitis: Past or present uveitis anterior, confirmed by an ophthalmologist Dactylitis: Past or present dactylitis, diagnosed by a doctor Psoriasis: Past or present psoriasis, diagnosed by a[rheumtutor.com]
Entire Body System
Chills
- CASE PRESENTATION: A 33-year-old woman presented with fever, chills, and acute episodes of low back pain. The sole unusual finding was pain upon spinal percussion, limited to the 4th and 5th lumbar vertebrae. Spinal MRI showed no abnormality.[ncbi.nlm.nih.gov]
- You should also tell your doctor if you are currently being treated for an infection or if you have or develop any signs of an infection such as: fever, sweat, or chills muscle aches cough shortness of breath blood in phlegm weight loss warm, red, or[simponi.com]
- […] are being treated for an infection have an infection that does not go away or that keeps coming back have TB or have been in close contact with someone with TB think you have an infection or have symptoms of an infection such as: fevers, sweats, or chills[cosentyx.com]
- Before starting CIMZIA, tell your healthcare provider if you: think you have an infection or have symptoms of an infection such as: fever, sweat, or chills muscle aches cough shortness of breath blood in phlegm weight loss warm, red, or painful skin or[cimzia.com]
- Fever (bouts of fever, chills)? Neurological symptoms 2. Physical examination Every physical examination should cover all organ systems.[harms-spinesurgery.com]
Rigor
- Treatment Physical therapy Consistent and rigorous physical therapy Independent exercises Medical therapy First choice: NSAIDs (e.g., indomethacin ) Additional options Tumor necrosis factor-α inhibitors (e.g., etanercept ) [12] In case of peripheral arthritis[amboss.com]
- He follows a rigorous exercise program aimed at building muscle and getting his blood moving more efficiently through his hips. Whether he’s at home in Las Vegas or on tour, Reynolds goes to the gym twice a week for weight training and conditioning.[practicalpainmanagement.com]
- […] through the nose and expiration through the mouth Encourage normal expiration through the nose and normal expiration through the mouth Deep breathing and then expiration through the mouth slowly Resistance exercises for inspiratory pulmonary muscles A rigorous[physio-pedia.com]
Musculoskeletal
Low Back Pain
- CONCLUSIONS: Epidemic myalgia should be considered when differentiating acute low back pain accompanied by fever.[ncbi.nlm.nih.gov]
- Her low back pain was relieved and low-grade fever and sweating disappeared. KEYWORDS: C-reactive protein; T-SPOT.TB; Tuberculous spondylitis; erythrocyte sedimentation; percutaneous kyphoplasty; percutaneous vertebroplasty; vertebral augmentation[ncbi.nlm.nih.gov]
- The most common symptom of ankylosing spondylitis is low back pain that develops so gradually you may not notice it in the early stages. If you've had low back pain for more than three months, see your doctor to have it checked out.[everydayhealth.com]
- The onset of disease is dated to the first appearance of symptoms of inflammatory low back pain or restricted spinal motion. Patients with a spondyloarthropathy other than AS may not participate.[clinicaltrials.gov]
- Alan Greene explains the symptoms, causes, treatment, and health risks of ankylosing spondylitis Symptoms AS starts with low back pain that comes and goes. Low back pain becomes present most of the time as the condition progresses.[mountsinai.org]
Spine Pain
- Morning stiffness of the spine. Pain and stiffness that worsens with immobility. Pain and stiffness that improves with physical activity. Symptoms which persist for more than three months. Thanks for your feedback![verywellhealth.com]
- As the inflammation progresses to involve more of the spine, there is decreased flexibility and range of motion of the spine. Pain may present along the spine and involve many spinal joints.[spinemd.com]
- Living Well with Ankylosing Spondylitis It can feel overwhelming to learn you have AS, but several treatments and lifestyle changes can help manage spine pain and even prevent disease progression.[spineuniverse.com]
- Other symptoms depend on the disease stage, and may include: Stiffness and limited motion of the lumbar spine Pain and limited chest expansion caused by involvement of the costovertebral joints Arthritis involving shoulders, hips and knees Kyphosis (curvature[healthcentral.com]
Oligoarthritis
- Up to 50% of AS patients develop asymmetric oligoarthritis ( 4 joints), often targeting the lower limb joints.[racgp.org.au]
Acute Low Back Pain
- CONCLUSIONS: Epidemic myalgia should be considered when differentiating acute low back pain accompanied by fever.[ncbi.nlm.nih.gov]
Workup
Microbiology
Salmonella Typhi
- KEYWORDS: Diabetic neuropathy; Retrograde pyelonephritis; Salmonella typhi[ncbi.nlm.nih.gov]
HLA Type
HLA-B27
- Many HLA-B27 positive don’t get AS, and some people without it do. Prevalence 2-8% (30% in eskimos!)[oxfordmedicaleducation.com]
- People with a family member with spondyloarthritis are at higher risk of developing spondyloarthritis depending on whether they inherited the HLA-B27 gene. About 90% of people who develop spondyloarthritis will carry the HLA-B27 gene.[spondylitis.ca]
- The risk of ankylosing spondylitis in 1st-degree relatives with the HLA-B27 allele is about 20%. Increased prevalence of HLA-B27 in whites or HLA-B7 in blacks supports a genetic predisposition.[msdmanuals.com]
- Not all allelles of HLA-B27 are at risk for B27 Syndromes, please check the HLA-B27 page for details.[snpedia.com]
- This is evidenced by the fact that the majority of people with spondylitis carry a gene called HLA-B27.[laserspineinstitute.com]
Treatment
- To prevent treatment failure and neurological deficits, it needs prompt diagnosis and sufficient effort to identify the causative organism.[ncbi.nlm.nih.gov]
- The outcomes of follow-up demonstrated that one-stage surgical treatment with anterior debridement, fusion, and instrumentation can be an effective and feasible treatment method for lumber brucella spondylitis.[ncbi.nlm.nih.gov]
- Treatment for tuberculous spondylitis was started. She underwent posterior fusion and instrumentation from T12-L5 after markers for infection returned to normal. After surgery, the patient continued antituberculous and anti-osteoporosis treatments.[ncbi.nlm.nih.gov]
- Antibiotics treatment was immediately started; however, she subsequently developed lumbar spondylitis, and long-term conservative treatment with antibiotics and a fixing device were required.[ncbi.nlm.nih.gov]
- What treatments are there for AS? Your rheumatologist will tailor your treatment to your symptoms and the severity of your condition. There is no way of predicting exactly which treatment will work best for you.[arthritiswa.org.au]
Prognosis
- CONCLUSIONS: Interleukin 12B (rs6871626) and IL-6R (rs4129267) gene polymorphisms could serve as promising biomarkers for diagnosis and prognosis in AS patients.[ncbi.nlm.nih.gov]
- […] of ankylosing spondylitis Most patients do well with exercise and analgesia 80% are employed Hip disease is more disabling than other components Indicators of poor prognosis: High ESR Poor response to NSAIDs NB the rigid AS spine requires very little[oxfordmedicaleducation.com]
- Further Reading Ankylosing Spondylitis Symptoms Ankylosing Spondylitis Pathophysiology Ankylosing Spondylitis Diagnosis Ankylosing Spondylitis Treatment Ankylosing Spondylitis Prognosis[news-medical.net]
- Prognosis The prognosis for many patients with AS will be complete spinal ankylosis, while others will experience intermittent flares between bouts of clinical remission.[hopkinsarthritis.org]
Etiology
- Etiology The precise etiology of AS remains mostly unknown, though heritability is frequently cited as a significant contributor. Major histocompatibility alleles, particularly HLA-B27, may account for up to one-third of the genetic effect.[hopkinsarthritis.org]
- Idiopathic The precise etiology is unclear. Genetic Although the precise cause of Ankylosing Spondylitis is unknown, there is a strong genetic component, i.e. HLA-B27.[veterans.gc.ca]
- Etiology Genetic predisposition : 90–95% of patients are HLA-B27 positive .[amboss.com]
- It is a chronic inflammatory rheumatic disease with unknown etiology. AS is associated with the HLA-B27 antigen and also with other chronic inflammatory diseases.[physio-pedia.com]
Epidemiology
- H. cinaedi infections have been increasingly reported in recent years, but the pathogen's epidemiological and pathological characteristics are still unclear.[ncbi.nlm.nih.gov]
- Epidemiology of spondyloarthritis in North America. Am J Med Sci 2011;341(4):284-6. Dillon CF, Hirsch R. The United States National Health and Nutrition Examination Surveyand the epidemiology of ankylosing spondylitis.[hopkinsarthritis.org]
- Epidemiology Sex : (3:1) Age : 15–40 years Lifetime prevalence in the US : 0.5% References: [1] [2] Epidemiological data refers to the US, unless otherwise specified. Etiology Genetic predisposition : 90–95% of patients are HLA-B27 positive .[amboss.com]
- Ankylosing spondylitis epidemiology Ankylosing spondylitis may affect people at any age beyond adolescence. It usually begins between ages 15 and 35 years (average 26 years).[news-medical.net]
Sex distribution
Age distribution
Pathophysiology
- The pathophysiology probably involves immune-mediated inflammation.[msdmanuals.com]
- Further Reading Ankylosing Spondylitis Symptoms Ankylosing Spondylitis Pathophysiology Ankylosing Spondylitis Diagnosis Ankylosing Spondylitis Treatment Ankylosing Spondylitis Prognosis[news-medical.net]
- The pathophysiology probably involves immune-mediated inflammation. Most patients have predominantly axial involvement (called axial ankylosing spondylitis). Some have predominately peripheral involvement.[msdmanuals.com]
- The pathophysiology probably involves immune-mediated inflammation. Classification Most patients have predominantly axial involvement (called axial ankylosing spondylitis). Some have predominately peripheral involvement.[merckmanuals.com]
Prevention
- To prevent treatment failure and neurological deficits, it needs prompt diagnosis and sufficient effort to identify the causative organism.[ncbi.nlm.nih.gov]
- It’s not known how you can prevent ankylosing spondylitis, because no one knows what causes it in the first place.[healthline.com]
- You should also consider putting some fall prevention measures in place at home, as an inflexible spine is at greater risk of fracture.[spineuniverse.com]
- Since there is no known cause for ankylosing spondilitis, there are no real preventative measures. The best option is in preventing AS from becoming worse.[belmarrahealth.com]
- The second group of medications control the disease and prevent long-term damage.[rheuminfo.com]