Ankylosing Spondylitis In Clinical Practice
Ankylosing spondylitis is a chronic form of arthritis known to affect around 1 in 200 people (over 1 million sufferers in the USA alone). No cure has yet been found for the disease, however, early diagnosis and proper medical management can be important i
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Joachim Sieper • Jürgen Braun
Ankylosing Spondylitis In Clinical Practice
Joachim Sieper Charité University Hospital Campus Benjamin Franklin Berlin, Germany
ISBN 978-0-85729-179-0 DO oI 10.1007/978-0-85729-180-6
Jürgen Braun Rheumatology Center Ruhrgebiet Herne, Germany
e-ISBN 978-0-85729-180-6
© Springer-Verlag London Limited 2011 Previously published in 2009 by Current Medicine Group Ltd. as Clinician’s Manual on Ankylosing Spondylitis (ISBN: 978-1-85873-436-1)
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Contents Author biographies
vii
Acknowledgements
ix
Abbreviations
xi
1 Introduction
1
A historical perspective
2 Overview of ankylosing spondylitis
1 5
The concept/classification of spondyloarthritis
5
Epidemiology of ankylosing spondylitis
6
Aetiopathogenesis of ankylosing spondylitis Genetics of ankylosing spondylitis
3 Clinical manifestations of ankylosing spondylitis
9 11 13
Inflammatory back pain
13
Restriction of spinal mobility
14
Extraspinal rheumatic manifestations
19
Enthesitis in peripheral joints
20
Extraarticular locations
22
Juvenile-onset spondyloarthritis
23
4 Diagnosis of ankylosing spondylitis
25
The modified New York criteria
25
Delay between onset of symptoms and diagnosis
27
Screening for axial SpA among patients with chronic back pain
35
The value of HLA-B27 for screening and diagnosis of axial SpA
36
5 Imaging in ankylosing spondylitis
39
Radiographs
39
Magnetic resonance imaging
43
Other imaging techniques
47
6 Management of ankylosing spondylitis Non-drug treatment
49 51
Drug treatment
51
Which patients should be treated with TNF blockers?
65
vi • contents
Prognostic parameters in ankylosing spo
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