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Ankylosing Spondylitis

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The patient is a 35-year-old male who was diagnosed with ankylosing spondylitis five years prior. Because of deterioration of patient’s left hip, a total hip replacement (THR) surgery is recommended by his rheumatologist. The patient has a past medical history of mild hypertension and anterior cruciate ligament repair to his right knee 12 years ago. Medications the patient is currently taking are Tenormin (Beta-blocker), Prednisone (Corticosteroid), and Ibuprofen (NSAID/ nonsteroidal anti-inflammatory drug). Physician’s referral consists of pre-surgery LE strengthening exercises, activities of daily living (ADL) training, and THR management education within 6 outpatient visits. Ankylosing spondylitis (AS) is a type of chronic inflammatory …show more content…
The inflammation usually begins at the base of the spine at the pelvis and may develop into the upper spine, rib cage, and neck. The hip and knee joints may also be affected. Prolonged inflammation of these joints may cause these spinal bones to fuse together. Baraliakos and Braun (2010) study found the following: Hip involvement in AS seems to be largely based on inflammation of the subchondral bone marrow. However, in contrast to the classical changes of AS in the spine, rheumatic inflammation in the hip does not lead to formation of new bones, but results in an erosive disease, which will often destroy the joint. These changes might have already occurred in young patients, and total hip replacement is often the therapy of choice in this difficult clinical situation, which leads to dramatic improvements of function in most cases (p. 3-4). Ankylosing spondylitis most commonly affects males in their 40’s and younger. Early symptoms of ankylosing spondylitis have a gradual onset of pain and stiffness that usually begins in the lower back, hips, and buttocks around the sacroiliac joints and worsens with immobility. Pain and stiffness may develop up the spine and into the neck and rib cage. Also, in the …show more content…
Ankylosing spondylitis is a systemic disease which can also cause complications involving the heart, lungs, and eyes due to inflammation. Eye inflammation (called iritis or uveitis) occurs in more than one-fourth of people with ankylosing spondylitis that causes redness and pain in the eye that worsens with exposure to bright light ("Ankylosing Spondylitis Symptoms," n.d.). The cause of ankylosing spondylitis is unknown but genetics as well as infection take part in the development of this disease. Currently, there is no known cure for AS, but there are treatments and medications available to reduce symptoms and manage pain ("Ankylosing Spondylitis," n.d.). Medications commonly prescribed for ankylosing spondylitis symptoms are NSAID/nonsteroidal anti-inflammatory drug (reduces hormone that produces inflammation and pain reliever), Corticosteroids (Prednisone-anti-inflammatory medication for pain relief only lasting for a short period and long term uses produces harsh side effects), and DMARDs/Disease-modifying Antirheumatic Drugs (Sulfasalazine-pain reliever and reduces swelling only in small joints to reduce pain). Other

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