Ankylosing Spondylitis 1 Ankylosing Spondylitis Marie-strumpell, Bechterew, (pelvospondylitis ossificans). (ossification), (sacroiliac joint),.,.,,.,.., NSAIDs(Non-Steroidal Anti-Inflammatory Drugs),. 1. HLA-B27. ( ). 95% B27. 2. 8-10 ( 0.6%) 15-40. 10.,,,. : 30 3. (sacroiliac joint), (lordosis),.,. (costo-vertebral joint),.,.,..
Ankylosing Spondylitis 2 4. (CT, Computer Tomography scanning),.. - (erosion).. (spine apophyseal jt.), (annulus fibrosis), anterior/lat -eral spinal ligament periosteal newbone,,,, sterno-man -ubrial jt.. - (erosion),. -... (bamboo spine).,, (annulus fibrosis), (spinous process) (osseous bridge)., (bamboo spine). 5., RF HLA, B27 95%, 6-10%,. 6. (1) AS,.,. (2) :,,, (lordosis) curve pelvis posterior tilting (posterior facet jt., apophyseal jt.) (3),,,, (bony ankylosis).,
Ankylosing Spondylitis 3.,,. (plantar fascia). long anterior ligament,.,. (4). enthesis enthesopathy....... (cauda equina syndrome) radicular symptom. (5) :, (6) (Thoracopulmonary function).. (stiffness) (glenohumeral jt.) (costovertebral jt.) & (sternocostal jt.), (costal n.). :, (7).., (tightness) (8).
Ankylosing Spondylitis 4. (9) 10-30%. nongranulomatous anterior uveitis(, 20-25%), spondylitic heart disease(3-5%) : atrioventricular conduction defect, (aortic insufficiency). 2 (amyloidosis). ( ) (anemic).,. Csohn, Reiter. 7....,,. ( )., hip. 8. (1) : (2) finger-floor distance :. (3) occiput/tragus to wall distance :.. (4) chin-chest distance or cervical flexion (5) chest expansion (6) vital capacity
Ankylosing Spondylitis 5 (7) cervical rotation (8) spondylometer( ) :. (9) Schober test : increase of 10cm distance above sacrolumbar junction in maximal lumbar foward flexion #.. 9. (1)..,,., HLA-B27. (2) differential Dx..,,. RA AS SI. AS subcutaneous nodule. AS rheumatoid.,,, low back pain - Reiter's syndrome, (psoriasis),. 10.,.,.,,,. (1) (NASIDs) indomethacin : 25-50mg, 3 naproxen, fenoprofen, tolmetin, sulindac, piroxicam,,,,,,,
Ankylosing Spondylitis 6 (indomethacin, phenylbutazone).. NSAID. Phenylbutazone, indomethacin. (2) (kyphosis),..,,.,.,. (3),.,,,. (pelvic osteotomy).,. 11. * (functional impairment :,,, ). 1. 2. 3. 4... (1) systemic resting. complete bed : systemic & articular inflammation : mild inflammation rest 2,. physical activity,.
Ankylosing Spondylitis 7 articualr rest (relaxation), (stretch), 15.. :. : crutch brace. (2),, pool gymnastics : / (.) : (.) -2, 25-30 (3), radiant or moist heat : paraffin bath :, morning stiffness : (4) (Assistive device), : grab bar, cane. - cane. walker crutch. (5) (Splint),, - night splint -. corticosteroid. - :. - :, - : simple right-angle type
Ankylosing Spondylitis 8. motion ROM (removable). (correction splint).. (6),, (SLR ). /. - -. - low back pain,.. -,,, (laser), superficial cold, - soreness /.,.., mobilization technique :,,,, mobility exercise,( low back pain.),, curve, pelvic tilting exercise., curve.. #..,
Ankylosing Spondylitis 9 15-30. (7) AROM.. - - - -. -,. -. -, - - (8).(,, ) ( ). - (.)... - ( ). ( ),,,,. -. -.....
Ankylosing Spondylitis 10. -, * 1. 2. (postural awareness). 3.. 4.,. 5. (daily exercise regimen).,... 3. (9)..... *. 1.. 2.,. 3.. (10) soft type game > hard contact game. (11) :,, Steinbrocker's score dancing groups, open air activity, health education, leisure, ergotherapy :. (12) /..,. (antibiotic). ( )
Ankylosing Spondylitis 11.. family education :. (13) ROM - ( 8-12 ) (.) (pulley sling )