scholarly journals Retrospective Diagnosis of Ankylosing Spondylitis after Spinal Fractures: A Review of 3 Cases and Clinical Implication

2021 ◽  
pp. 173-179
Author(s):  
Kamran Farooque ◽  
Santanu Kar ◽  
Burhan Salim Siamwala ◽  
Vijay Sharma
Keyword(s):  
Ankylosing Spondylitis ◽  
Young Patients ◽  
Treatment Protocol ◽  
Spinal Fractures ◽  
Low Energy ◽  
Low Velocity ◽  
Retrospective Diagnosis ◽  
Younger Age ◽  
Fracture Management ◽  
Strong Suspicion

Ankylosing spondylitis (AS) is an underdiagnosed inflammatory condition in the initial stages of disease that can cause vertebral fractures in young adults after trivial trauma. Hence, low-energy spinal fractures in young patients must be carefully evaluated to exclude AS as the treatment protocol (fixation levels, period of immobilization) may change drastically if AS is diagnosed. Here, we present cases of 3 patients who presented at emergency after low-velocity spinal trauma and diagnosed as AS during workup for fracture management. This cases series indicates underdiagnosis of AS in general population as well as importance of strong suspicion of AS in low-energy spinal fractures in the younger age-group.

scholarly journals POS1012 HOW IMPORTANT WOULD BE THE IMPACT OF SPONDYLOARTHRITIS ON MILITARY POPULATION’S WORKING LIFE?

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 774.2-774
Author(s):  
T. Mehmli ◽  
R. Dhahri ◽  
M. Slouma ◽  
E. Hannech ◽  
B. Louzir ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Activity Index ◽  
Productivity Loss ◽  
Young Patients ◽  
Work Productivity ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Military Patients ◽  
The Impact

Background:Spondyloarthritis is a group of chronic inflammatory diseases involving axial and peripheral joints. It mainly affects young patients typically of working age. Therefore, its impact on work outcomes may be considerable particularly in military patients.Objectives:The aim of this study was to evaluate the impact of spondyloarthritis on work ability and productivity in military patients, and to assess relationship between work productivity loss and disease activity.Methods:Thirty Three patients diagnosed with spondyloarthritis in the militay hospital of Tunis were included in the study. Age, gender and C-reactive protein were recorded. Data related to duration of the disease, Ankylosing Spondylitis Disease Activity Score (ASDAS) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) were also recorded. Employed patients completed Work Productivity and Activity Impairment (WPAI) questionnaire witch assesses four subscales: presenteism, absenteism, overall work impairemend and daily activity impairement in the 7 past days.Results:Among the thirty three patients, 63 % were men and 37% were women. The average age was 43,7 ± 13,5. The average duration of disease was 8,5 ± 7,75 years. Mean C-Reactive protein was 27,5 ± 39,3. Mean ASDAS and BASDAI were 3,12 ± 1,39 and 4,26 ± 1,78 respectively. 22 patients (66%) had an active disease and 11 (33%)were in remission. 48,4% of patients were using NSAIDs, 48,4% were under DMARDs and 42% were under biologics (12 patients using TNF-alpha blockers and 2 patients were given IL-17 inhibitors). Among this patients, 27 were employed. Three patients (11%) had a total work disability and were retired from work and two have been outplaced.Employed patients worked an average of 35,6 ± 10,3 hours per week and missed an average of 3,48 ± 6,49 hours per week. The mean rates of absenteeism, presenteeism and work productivity loss were 8,8 ± 16,9 %, 48,4 ± 19,9 % and 48,6 ± 19,7 %.There was a statistically significant correlation between BASDAI and work missed hours (p<0,05, r=0,48), absenteeism (p<0,05, r=0,48), presenteeism (p<0,01, r=0,669), work impairement (p<0,01, r=0,669), activity impairement (p<0,05, r=0,475) and work productivity loss (p<0,05, r=0,475), as well as between ASDAS CRP and presenteeism (p<0,05, r= 0,593), work impairement (p<0,05, r=0,593), activity impairement(p<0,05, r=0,460) and work productivity loss (p<0,05, r=0,460). No relation was found between WPAI indexes and C-reactive protein.Conclusion:This study demonstrates that spondyloarthritis has a major impact on military patients’ work productivity with a significant correlation between WAPI indexes and disease activity scores (ASDAS CRP and BASDAI). No relation was found with C-reactive protein.Disclosure of Interests:None declared.

scholarly journals Surgical outcome after spinal fractures in patients with ankylosing spondylitis

2009 ◽  
Vol 10 (1) ◽  
Author(s):  
George Sapkas ◽  
Konstantinos Kateros ◽  
Stamatios A Papadakis ◽  
Spyros Galanakos ◽  
Emmanuel Brilakis ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Surgical Outcome ◽  
Spinal Fractures

Cauda Equina Syndrome in Ankylosing Spondylitis: Challenges in Diagnosis, Management, and Pathogenesis

2019 ◽  
Vol 46 (12) ◽  
pp. 1582-1588 ◽  
Author(s):  
Chen Tang ◽  
Franklin G. Moser ◽  
John Reveille ◽  
Jane Bruckel ◽  
Michael H. Weisman
Keyword(s):  
Ankylosing Spondylitis ◽  
Medical Records ◽  
Cauda Equina Syndrome ◽  
Early Recognition ◽  
Laboratory Data ◽  
Cauda Equina ◽  
Spinal Fractures ◽  
Neurologic Complication ◽  
Facet Joints ◽  
Imaging Studies

Objective.Cauda equina syndrome (CES) is a rare neurologic complication of longstanding ankylosing spondylitis (AS). It is unclear what causes CES, and no proven or effective therapy has been reported to date. We have encountered 6 patients with longstanding AS diagnosed with CES. We set about to study their features, review the literature, and generate hypotheses regarding pathophysiology, as well as to speculate on the possibilities of early recognition and prevention.Methods.We obtained permission from 6 patients with longstanding AS and CES to access their medical records and imaging studies for research purposes related to this paper. We collected and reviewed each patient’s medical history, imaging studies, disease duration, past therapies especially those that relate to AS, laboratory data, as well as any treatment they received for CES and followup results of each case to the present time.Results.The 6 cases of CES with AS have remarkable similarity to each other in that several decades of the disease had passed before neurologic symptoms and later signs appeared. All cases have fused spines and facet joints without spinal fractures, spinal stenosis, or disc herniation.Conclusion.CES is a rare yet debilitating neurologic complication of longstanding AS. The pathophysiology and treatments are far from clear. We postulate that chronic enthesitis of the vertebral column initiates the process that results in dural stiffening and formation of ectasias, causing downstream nerve root damage.

scholarly journals Younger age of patients with myocardial infarction correlates with higher number of relatives with history of premature atherosclerosis

2020 ◽  
Author(s):  
Michał Ambroziak ◽  
Katarzyna Niewczas-Wieprzowska ◽  
Agnieszka Maicka ◽  
Andrzej Budaj
Keyword(s):  
Myocardial Infarction ◽  
Family History ◽  
Young Patients ◽  
Significant Risk ◽  
Control Group ◽  
Premature Coronary Artery Disease ◽  
Premature Atherosclerosis ◽  
Global Issues ◽  
Younger Age ◽  
History Of

Abstract Background. Premature coronary artery disease belongs to the most pressing global issues in a modern cardiology. Family history appears to be one of the most important and significant risk factors in young patients with myocardial infarction (MI). The aim of the study was to investigate the role of family history of premature cardiovascular disease (CVD) in patients <50 years with myocardial infarction (MI) compared to patients ≥ 50 years with MI and to young healthy people.Methods. The studied group (MI<50) consisted of 240 patients aged 26-49 years with MI. The control groups consisted of 240 patients (MI≥50) with MI aged 50-92 years and 240 healthy people aged 30-49 years.Results. There were statistically significant differences between the MI<50 and MI≥50 and young healthy groups regarding family history of premature MI/ischaemic stroke and percent of patients with of ≥2 relatives affected including parents, children, siblings, siblings of parents and grandparents (10.8%, 2.9%, 3.7%, respectively; p<0.0001). There was a statistically significant negative correlation between the age of the first episode of MI and the number of relatives with a history of premature MI/stroke (r=0.249, p<0.05) within all MI patients. Statistically significant differences between MI<50 and MI≥50 groups as well as young healthy control group were revealed regarding prevalence of smoking, body mass index (BMI), LDL, HDL, triglycerides (TG) and glucose levels.Conclusions. Younger age of patients with myocardial infarction correlates with a higher number of relatives with a history of premature MI/ischemic stroke. Thus, the family history of premature atherosclerosis involving not only the first-, but also the second-degree relatives, seems to be valuable and could be considered in an individual CVD risk evaluation in young people.

scholarly journals Low velocity drop weight impact behavior of Al2O3-Ni-ZrO2 and Al2O3-Ni-Cr2O3 nanocomposite systems

2021 ◽  
Author(s):  
Betül Kafkaslıoğlu Yıldız ◽  
Murat Büyük ◽  
Yahya Kemal Tür
Keyword(s):  
Network Formation ◽  
Low Energy ◽  
Impact Behavior ◽  
Precipitation Method ◽  
Low Velocity ◽  
Ballistic Performance ◽  
Crack Network ◽  
Damage Mechanisms ◽  
Drop Weight ◽  
Weight Impact

Abstract 1 vol% Ni particulate Al2O3 matrix nanocomposites prepared by the heterogeneous precipitation method with ZrO2 (5 vol%) or Cr2O3 (1 vol%) additives were subjected to the low energy drop weight impact tests to compare the behavior of the compositions under low energy impact and to investigate the damage mechanisms. The pure Al2O3, Al2O3/Ni, Al2O3/ZrO2, and Al2O3/Cr2O3 compositions with the same additive ratios were also produced to make the comparison systematically. Also, the Vickers hardness measurements were carried out and a significant increase in hardness was attained for both Al2O3/Ni + ZrO2 and Al2O3/Ni + Cr2O3. The average hardness value around 24.8 ± 1.0 GPa was measured for Al2O3/Ni + ZrO2 and Al2O3/Ni + Cr2O3 which means ∼ 15% improvement compared to the pure Al2O3. Between all the compositions, the maximum force (Fmax) value was obtained for Al2O3/Ni + ZrO2 for 12 J impact energy level (26617 N) according to the low energy drop weight impact test results. Tensile radial crack network formation, cone formation, fracture and crushing of the cone structure were observed as damage mechanisms for all the compositions. The volume of conical frustum structure was evaluated for each composition and the effect of microstructure on possible ballistic performance was also discussed.

No differences of carotid intima–media thickness between young patients with ankylosing spondylitis and healthy controls

2008 ◽  
Vol 75 (5) ◽  
pp. 548-553 ◽  
Author(s):  
Jung-Yoon Choe ◽  
Myoung-Yong Lee ◽  
Insoo Rheem ◽  
Moo-Yong Rhee ◽  
Sung-Hoon Park ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Young Patients ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Healthy Controls ◽  
Media Thickness

Bilateral isolated C5 paralysis of the shoulder: Atypical presentation of a transdiscal C4-C5 cervical spine fracture

2021 ◽  
Vol 14 (3) ◽  
pp. e236323
Author(s):  
Elisa Mareddu ◽  
Aurélien Traverso ◽  
Pietro Laudato ◽  
Stefan Bauer
Keyword(s):  
Cervical Spine ◽  
Spinal Injury ◽  
Spinal Fractures ◽  
Low Energy ◽  
Cervical Spine Fracture ◽  
Atypical Presentation ◽  
American Spinal Injury Association ◽  
Initial Imaging ◽  
Clinical Awareness ◽  
Diagnostic Index

After a low-energy fall, an 83-year-old man presented with bilateral weakness of the upper arms without loss of sensation associated with a rigid cervical spine (ankylosing spinal disorder, ASD). Because of an atypical presentation during history, examination and initial imaging, a late diagnosis of a transdiscal C4-C5 fracture was made by dynamic radiographs. Anterior cervical discectomy and fusion were performed with delay. Strength improved from grade C to D (American Spinal Injury Association classification) after surgery. To our knowledge, this is the first description of a bilateral, isolated upper limb C5 paralysis without any loss of sensation caused by a transdiscal C4-C5 fracture. A high clinical and diagnostic index of suspicion is mandatory to make the diagnosis. We present three clinical ‘Awareness Criteria’ (1: recognition of ASD; 2: high index of fracture suspicion; 3: necessary imaging) helping clinicians to safely and promptly diagnose occult spinal fractures in ASD.

Complications of axial spondyloarthritis

2016 ◽  
Author(s):  
Stefan Siebert ◽  
Sengupta Raj ◽  
Alexander Tsoukas
Keyword(s):  
Ankylosing Spondylitis ◽  
Cardiovascular Events ◽  
Axial Spondyloarthritis ◽  
Spinal Fractures ◽  
Neurological Complications ◽  
Cardiac Complications ◽  
Minor Trauma ◽  
Conduction Disturbances ◽  
Increased Risk ◽  
Mechanical Constraint

In addition to the well-recognized extra-articular manifestations (EAMs) of ankylosing spondylitis (AS), this condition can also be associated with a number of clinically important complications. While EAMs are considered part of the spondyloarthritis (SpA), the complications are generally a consequence of having the disease. Patients with AS are at increased risk of osteoporosis and spinal fractures. The latter may occur after seemingly minor trauma and may lead to significant neurological compromise. Other potential neurological complications include atlantoaxial subluxation and compressive radiculopathy or myelopathy. Cardiac complications include cardiovascular events, valvular disease, and conduction disturbances. Pulmonary disease in AS relates to parenchymal involvement or mechanical constraint from chest wall inflammation. Renal disease is generally rare in AS.

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