英文-強(qiáng)直性脊柱炎課件

ANKYLOSINGSPONDYLITISAnkylosingSpondylitisIntroductionEtiologyClinicalfeature&DiagnosisTreatmentIntroductionAnkylosingSpondylitis(AS)isachronicseronegativein-flammatorydiseasethataffectstheaxialskeleton,especia-llythesacroiliacjoints,hipjoints,andspine.Extraskeletalinvolvementisfoundintheaorta,lung,anduvea.Thecharacteristicsofthisdiseaseisthesacroilitis,whichspreadupwardslowlytothespine,finallycausecompleterigidityor(and)deformityofthespine.

Thediseaseusuallyhasitsonsetduringearlyadulthoodandmalesareaffectedmorefrequentlythanfemaleswiththemale/femaleratioof2-7:1.Clinicalfeature&DiagnosisPeakonset:between20and30yearsofage.Theinitialsymptomsareinsidiousandadvancegradually,includingpaininthebuttocks,heels,andlowback,sometimescompaniedbysystemicfeatures,suchasfatigue,anorexia,mildfeverandweightloss.Attheoutset,thepainisintermittent,thenitgraduallybecomedurativewhenthediseaseprogess.Eventually,somepatientsdevoloplossofmotionandsubsequentlossofkyphosisinthecervicalandlumbarspine。Clinicalfeature&DiagnosisSpondylitis，startsinthesacroiliacjoint,graduallymigratescephaladtolumbar,thoracic,andcervicalspine.Painandlossofmotionofthelowbackarecausedbysacroilitisjointandlumbarspineinvolved.Themyalgiaofthebackisdiffuseatfirst,andthenisfocusedonthelumbosacral

vertebraes.Clinicalfeature&DiagnosisTerminalchangeofthespine:

Cervical:anteflexion

Thoracic:kyphosisandchesttightness.lumbar:kyphosis.HipandKnee:flexioncontractureClinicalfeature&DiagnosisPeripheraljointsinvolved:

shoulderandhip:40%respectively

knee:15%

ankle:10%

wristandfoot:5%respectively

hand:seldominvolvedExtraskeletalinvolvement:

uveitis:30%;chesttightness:30%;aorta:lessthan5%

Clinicalfeature&Diagnosis2.Imagingstudies

Radiographicexamination：a.symmetricbilateralbonyerosionsfollowedbybonysclerosisofthesacroiliacjoints;b.ankylosisofthelumbarspine:theso-calledbamboospine.Clinicalfeature&DiagnosisLaboratoryInvestigationsInflammationmarkers:sensitivebutnon-specifica.C-reactiv