MEDICAL SURGICAL

NURSING

ANKYLOSING SPONDYLITIS

PRESENTED BY
Ms. Aruna Jadav
ANKYLOSING SPONDYLITIS
 DEFINITION

 Ankylosis spondylitis is a chronic

inflammatory disease that primarily affects the
axial skeleton. It leads to pain , stiffness and
fusion of spine.

 It effects sacroiliac joints, intervertebral disc

spaces and costovertebral articulations.
 AREAS MOST COMMONLY
AFFECTED:-
 The Spine
 Neck
 Ribs
 Shoulder Joints
 Hips
 Thighs
 Joints of the Hands and Feets
ETIOLOGY / RISK FACTORS
 The exact cause is unknown.
 Genetics And Family History
 Age
 Sex (more develop in men rather than women)
 Infection (bacteria, fungi, virus)
 PATHOPHYSIOLOGY
Due to Etiology and Risk factors
Autoimmune response occurs

Inflammation of joints and surrounding tissues

Pannus ( granulation tissue) formation that

destroy the bone and cartilage

Calcification and fusion of articular tissue

PATHOPHYSIOLOGY

Joint fusion and Immobility

LUMBER LOST CURVED SHAPE
CLINICAL MANIFISTATION
 Pain in lower back, buttocks, hips or down the legs.
 Stiffness in lower back, hips and buttocks ( during
night and morning)
 As disease progresses – lumber lost the curve shape
and impair mobility.
 Other symptoms include fever, fatigue, anorexia and
weight loss.
STIFFNESS AND IMPAIR MOBILITY
DIAGNOSTIC EVALUATION
 History collection
 Physical Examination
 CBC (Complete blood count)
 CRP (C- reactive protein)
 ESR (Erythrocyte Sedimentation Rate )
 X-Rays
 MRI Scan
INVESTIGATION
 COMPLICATION
 Spine related issues (nerve roots situated in
bottom of the spinal cord as the damage
vertebrae may cause problems in
bladder/bowel control, loss of reflexes etc.
 Uvetitis (eye inflammation with light
sensitivity and blurry vision.
 Cardiac issues
UVETITIS
 MANAGEMENT
 Medical Management
 Non steroidal Anti-Inflammatory drugs (NSAIDS)
Ex. Indomethacin used to treat stiffness.
 Topical corticosteroids (Ex. Sulfasalazine or
Methotrexate.
 Anti-TNF (Tumor necrosis Factor)- Ex. Infliximab
adalimumab may be effective to reduce
inflammation.
 Physiotherapy to improve range of motion and
posture.
PHYSIOTHERAPY
 SURGICAL MANAGEMENT
 Artificial joint replacement
surgery(Arthroplasty)
 Spinal Osteotomy (a surgical procedure in
which a section of the spinal bone is cut and
removed to allow for correction of spinal cord)
ARTIFICIAL JOINT REPLACEMENT
SPINAL OSTEOTOMY
 NURSING MANAGEMENT
 Acute pain related to vertebral and joint
inflammation as evidenced by pain scale.
 Activity intolerance related to vertebral and
joint inflammation and pain as evidenced by
verbalization, generalized weakness, fatigue
 Impaired physical mobility related to vertebral
and joint inflammation as evidenced by severe
pain, verbalization.