Keywords for Investigation, Referral and Journal Writing in Ankylosing Spondylitis 4/5 (7)

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Ankylosing spondylitis is suspected of:

  • Disease history

  • Clinical examination

    • Posture
      • Increased thoracic kyphosis
      • Flattened lumbar lordose
      • Flexed (bent) hip joint
    • Movement (all three planes: extension, flexion, lateral flexion) in the neck (cervical colum), thoracic column (thoracic columnar, thoracic excursion less than 2,5cm in 4. Intercostal space) and lumbar (lumbar columnar)
    • Distance between the head (occiput) and a wall when standing as close to the wall as possible with the entire back
    • Schober's test of the lower back
    • Finger-floor distance by forward bending
    • The circumference of the thorax at maximum in and out (thoracic excursion)
    • Arthritis of knees, Baker's cyst in knee hase (popliteal)
    • Movement of the hips
      • Hip-arthritis (reduced internal rotation)
    • Pain during provocation tests against iliosacral joints
    • Achilles tendons and plantar facies (entesopathy)
    • Eyes: Uveitis-sequelae
    • Auscultation of the heart (heart rhythm disorders, aortic valve insufficiency)
    • Urine: proteinuria by AA-amyloidosis (Secondary due to prolonged illness)
  • Radiological examinations

  • Blood tests

    • CRP elevated in most cases
    • HLA B27 + (genetic factor) exists in excess of 95% (8-10% of normal Norwegian population)

Bekhterev's disease,

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