英文-强直性脊柱炎教材课程.pptVIP

ANKYLOSING SPONDYLITIS Etiology Heredity factor Approximately 90% of people with AS express the ? HLA-B27 ?genotype and 1-2% of individuals with the HLA-B27 genotype contract the disease, meaning there is a strong genetic association. Infection The disease is commonly conmitant with prostatitis, ulcerative colitis and pelvic infection, so investigators have postulated that infection is?one?of the?etiological?agent for the disease. 3. Autoimmunity Auto-antibodies specific for AS have not been identified. Anti-neutrophil cytoplasmic antibodies?(ANCAs) are associated with AS, but do not correlate with disease severity. Clinical feature Diagnosis Peak onset : between 20 and 30 years of age. The initial symptoms are insidious and advance gradually, including pain in the buttocks, heels, and low back, sometimes companied by systemic features, such as fatigue, anorexia, mild fever and weight loss. At the outset, the pain is intermittent, then it gradually become durative when the disease progess. Eventually, some patients devolop loss of motion and subsequent loss of kyphosis in the cervical and lumbar spine。 Clinical feature Diagnosis Spondylitis，starts in the sacroiliac joint, gradually migrates cephalad to lumbar, thoracic, and cervical spine. Pain and loss of motion of the low back are caused by sacroilitis joint and lumbar spine involved. The myalgia of the back is diffuse at first, and then is focused on the lumbosacral vertebraes. Clinical feature Diagnosis Terminal change of the spine: Cervical: anteflexion Thoracic: kyphosis and chest tightness. lumbar: kyphosis. Hip and Knee: flexion contracture Clinical feature Diagnosis Peripheral joints involved: shoulder and hip: 40% respectively knee: 15% ankle: 10% wrist and foot: 5% respectively hand: seldom involved Extraskeletal involvement: uveitis: 30%