CLINICAL ENCOUNTERS
ANKYLOSING SPONDYLITIS
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Question
[CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]
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LBP & stiffness > 3 mnth, improves with exercise, not relieved by rest
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Limitation of lumbar spine motion in sagittal and frontal planes
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Decreased chest expansion
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Radiologic criteria
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Bilateral sacroiliitis grade 2 or higher, or unilateral sacroiliitis grade 3 or higher
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Detailed explanation-1: -*The modified New York criteria for ankylosing spondylitis are mostly used for classification. All three clinical and the radiographic criteria refer exclusively to axial involvement, including the spinal, costovertebral, costosternal, and sacroiliac joints.
Detailed explanation-2: -Sacroiliitis grading can be achieved using plain radiographs according to the New York criteria 1, 2. A patient is considered positive for radiographic sacroiliitis if the score is greater than or equal to grade II bilaterally or greater than or equal to grade III unilaterally 3.
Detailed explanation-3: -Grade 3: Unequivocal abnormality-moderate or advanced sacroiliitis consisting of erosion, sclerosis, widening, narrowing, and/or partial joint fusion (ankylosis). Grade 4: Severe abnormality in the form of total ankylosis.
Detailed explanation-4: -Sacroiliitis (say-kroe-il-e-I-tis) is a painful condition that affects one or both sacroiliac joints. These joints sit where the lower spine and pelvis meet. Sacroiliitis can cause pain and stiffness in the buttocks or lower back, and the pain might go down one or both legs.