Ankylosing spondylitis physical examination: Difference between revisions
Jump to navigation
Jump to search
| Line 12: | Line 12: | ||
* Vital signs are within normal limits in patients with AS. | * Vital signs are within normal limits in patients with AS. | ||
=== Cervical spine === | === Cervical spine <ref name="pmid242362552">{{cite journal |vauthors=Cho H, Kim T, Kim TH, Lee S, Lee KH |title=Spinal mobility, vertebral squaring, pulmonary function, pain, fatigue, and quality of life in patients with ankylosing spondylitis |journal=Ann Rehabil Med |volume=37 |issue=5 |pages=675–82 |date=October 2013 |pmid=24236255 |pmc=3825944 |doi=10.5535/arm.2013.37.5.675 |url=}}</ref>=== | ||
* Patient with ankylosing spondylitis(AS) shows forward stooping of the thoracic and cervical spine. | * Patient with ankylosing spondylitis(AS) shows forward stooping of the thoracic and cervical spine. | ||
* The degree of flexion deformity is measured by asking the patient to stand erect with heels and buttocks against a wall and to extend the neck, while keeping the mandible in horizontal position and ask the patient to touch the wall. | * The degree of flexion deformity is measured by asking the patient to stand erect with heels and buttocks against a wall and to extend the neck, while keeping the mandible in horizontal position and ask the patient to touch the wall. | ||
* The degree of flexion deformity is measured by the distance between the occiput and the wall. | * The degree of flexion deformity is measured by the distance between the occiput and the wall. | ||
=== Thoracic spine === | === Thoracic spine<ref name="pmid24236255">{{cite journal |vauthors=Cho H, Kim T, Kim TH, Lee S, Lee KH |title=Spinal mobility, vertebral squaring, pulmonary function, pain, fatigue, and quality of life in patients with ankylosing spondylitis |journal=Ann Rehabil Med |volume=37 |issue=5 |pages=675–82 |date=October 2013 |pmid=24236255 |pmc=3825944 |doi=10.5535/arm.2013.37.5.675 |url=}}</ref> === | ||
* The degree of chest expansion is measured by the range of motion of the costovertebral joints and is measured at the level of the xiphoid process. | * The degree of chest expansion is measured by the range of motion of the costovertebral joints and is measured at the level of the xiphoid process. | ||
* The physician must ask the patient to raise their arms beyond their heads and then ask the patient to maximal forced expiration how much they can and that is followed by a maximal inspiration. | * The physician must ask the patient to raise their arms beyond their heads and then ask the patient to maximal forced expiration how much they can and that is followed by a maximal inspiration. | ||
| Line 25: | Line 25: | ||
* In patients with AS Schober test is used to measure forward flexion of the lumbar spine. | * In patients with AS Schober test is used to measure forward flexion of the lumbar spine. | ||
* Physician must ask the patient to stands erect then a point is placed at the middle of a line joining the posterior superior iliac spines, another mark is made above 10 cm in the midline then ask the patient to bends forward how much they can without bending the knees and measure the distance. | * Physician must ask the patient to stands erect then a point is placed at the middle of a line joining the posterior superior iliac spines, another mark is made above 10 cm in the midline then ask the patient to bends forward how much they can without bending the knees and measure the distance. | ||
* In normal individuals | * In normal individuals should exceed 2 cm. | ||
==References== | ==References== | ||
Revision as of 15:09, 5 April 2018
|
Ankylosing spondylitis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Ankylosing spondylitis physical examination On the Web |
|
American Roentgen Ray Society Images of Ankylosing spondylitis physical examination |
|
Risk calculators and risk factors for Ankylosing spondylitis physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Patients with ankylosing spondylitis usually appear normal. Physical examination of patients with ankylosing spondylitis is usually remarkable for three areas 1)axial joints 2)peripheral joints and 3)entheses.Physical examination of AS include typical diagnostic process that includes exams and tests.The Physical examination of AS include Schober Test,Gaenslen Test,Chin-Brow Measurement,Chest Expansion and Range of Motion.
Physical Examination
- Physical examination of patients with ankylosing spondylitis is usually remarkable for three areas 1)axial joints 2)peripheral joints and 3)entheses.
Appearance of the Patient
- Patients with ankylosing spondylitis usually appear normal.
Vital Signs
- Vital signs are within normal limits in patients with AS.
Cervical spine [1]
- Patient with ankylosing spondylitis(AS) shows forward stooping of the thoracic and cervical spine.
- The degree of flexion deformity is measured by asking the patient to stand erect with heels and buttocks against a wall and to extend the neck, while keeping the mandible in horizontal position and ask the patient to touch the wall.
- The degree of flexion deformity is measured by the distance between the occiput and the wall.
Thoracic spine[2]
- The degree of chest expansion is measured by the range of motion of the costovertebral joints and is measured at the level of the xiphoid process.
- The physician must ask the patient to raise their arms beyond their heads and then ask the patient to maximal forced expiration how much they can and that is followed by a maximal inspiration.
- In normal individuals the expansion is usually >2 cm.
Schober test[3][4][5][6]
- In patients with AS Schober test is used to measure forward flexion of the lumbar spine.
- Physician must ask the patient to stands erect then a point is placed at the middle of a line joining the posterior superior iliac spines, another mark is made above 10 cm in the midline then ask the patient to bends forward how much they can without bending the knees and measure the distance.
- In normal individuals should exceed 2 cm.
References
- ↑ Cho H, Kim T, Kim TH, Lee S, Lee KH (October 2013). "Spinal mobility, vertebral squaring, pulmonary function, pain, fatigue, and quality of life in patients with ankylosing spondylitis". Ann Rehabil Med. 37 (5): 675–82. doi:10.5535/arm.2013.37.5.675. PMC 3825944. PMID 24236255.
- ↑ Cho H, Kim T, Kim TH, Lee S, Lee KH (October 2013). "Spinal mobility, vertebral squaring, pulmonary function, pain, fatigue, and quality of life in patients with ankylosing spondylitis". Ann Rehabil Med. 37 (5): 675–82. doi:10.5535/arm.2013.37.5.675. PMC 3825944. PMID 24236255.
- ↑ Yen YR, Luo JF, Liu ML, Lu FJ, Wang SR (2015). "The Anthropometric Measurement of Schober's Test in Normal Taiwanese Population". Biomed Res Int. 2015: 256365. doi:10.1155/2015/256365. PMC 4530222. PMID 26273601.
- ↑ Viitanen JV, Kautiainen H, Suni J, Kokko ML, Lehtinen K (1995). "The relative value of spinal and thoracic mobility measurements in ankylosing spondylitis". Scand. J. Rheumatol. 24 (2): 94–7. PMID 7747150.
- ↑ Haywood KL, Garratt AM, Jordan K, Dziedzic K, Dawes PT (June 2004). "Spinal mobility in ankylosing spondylitis: reliability, validity and responsiveness". Rheumatology (Oxford). 43 (6): 750–7. doi:10.1093/rheumatology/keh169. PMID 15163832.
- ↑ Cidem M, Karacan I, Uludag M (August 2012). "Normal range of spinal mobility for healthy young adult Turkish men". Rheumatol. Int. 32 (8): 2265–9. doi:10.1007/s00296-011-1953-4. PMID 21544633.