Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Pott’s diseaseBekhterev syndromeMarie-Strümpell diseaseRheumatoid spondylitisAnkylosing spondylitisSpondyloarthropathy ++ 720.81 Inflammatory spondylopathies in diseases classified elsewhere ++ M49.80 Spondylopathy in diseases classified elsewhere, site unspecified ++ 4B: Impaired posture14E: Impaired joint mobility, motor function, muscle performance, and ROM associated with localized inflammation24F: Impaired joint mobility, motor function, muscle performance, range of motion, and reflex integrity associated with spinal disorders3 +++ Description ++ Inflammation of one or more spinal vertebraeCan be localized due to infection of a certain spinal area, degenerative arthritis, or following a traumatic injury +++ Essentials of Diagnosis ++ Most characterized with sacroiliac (SI) joint pain and dysfunctionEtiology unknownAcute, painful flare-upsChronic, persistent painPain for longer than three monthsRelief with NSAIDsMorning stiffness +++ General Considerations ++ Begins with intermittent low back painImproved with low-level activityMay have rapid and severe onsetSecondary problemsPulmonary fibrosisRestrictive lung capacity +++ Demographics ++ Begins after age 40, though onset can be earlier due to trauma or infectionCan affect any age or gender +++ Signs and Symptoms ++ Loss of ROM and joint playIntermittent back painHeel painHip pain and stiffnessJoint pain and swelling in shoulders, knees, anklesThoracic and pulmonary involvement +++ Functional Implications ++ Limited mobilityAerobic endurance limitationMay impede ability to perform ADLs/IADLsMay impede participation in sports and other social activities +++ Possible Contributing Causes ++ TraumaOccupational factorsCongenital anomaliesPhysical conditionSmokingObesitySocio-economic factorsPsychosocial and behavioral factorsPostural changesWeakness of core musculatureTightness of hip flexors, hip external rotators, hamstringsDegenerative arthritisGastrointestinal infections +++ Differential Diagnosis ++ Ankylosing spondylitisSpinal stenosisDisc herniationCrohn’s diseaseForestier’s diseaseReiter’s syndrome (reactive arthritis)Whipple’s diseaseSystemic auto-immune diseases (rheumatoid arthritis, Reiter’s syndrome)SpondylosisSpondylitisSpondylolisthesisSpinal alignmentSacral dysfunctionErector spinae muscle strainMyofascial pain syndromeYersinia arthritisFacet joint arthritisPsoriatic arthritisRheumatoid arthritis +++ Laboratory Tests ++ To rule out systemic disease, differential diagnosisComplete blood count (CBC)Erythrocyte sedimentation rate (ESR)HLA-B27 antigen, genetic marker for ankylosing spondylitisNo single blood test can determine spondylitisNegative serologic tests for rheumatoid factor +++ Imaging ++ MRI helpful in diagnosis to visualize structure of ligament, compressed or inflamed nerve root, disc pathologyX-ray/plain-film radiograph helps to assess alignment, fractures, stability (flexion/extension radiograph)CT to show structure of ligament, herniation compressing the spinal canal/nerves, or to rule out abdominal pathologyElectrodiagnostic/nerve conduction testing can help determine specific impaired nerve functionDoppler ultrasound to examine vascular functionDiagnostic ultrasound to analyze fiber orientation... Your MyAccess profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth