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Could you try it again? We just pushed some changes and I tried your question: > Based on the information provided, the patient presents with lower back pain,
by johntiger1 3y ago
Could you try it again? We just pushed some changes and I tried your question:
> Based on the information provided, the patient presents with lower back pain, rib pain, and uveitis. These symptoms are suggestive of a seronegative rheumatic disease, specifically ankylosing spondylitis (AS).
The signs and symptoms mentioned in the text support this diagnosis. The patient has axial symptoms, including mid and lower back stiffness, morning stiffness lasting more than 1 hour, night pain, and persistent buttock pain. The FABER test, which involves flexion, abduction, and external rotation of the leg, is positive for sacroiliac joint pain. The patient also has spinal restriction, postural changes, and peripheral manifestations such as asymmetrical large joint arthritis, enthesitis, and dactylitis.
The extra-articular manifestations associated with AS, such as acute anterior uveitis, are also present in this patient. Other potential extra-articular manifestations include renal involvement (amyloidosis, IgA nephropathy), gastrointestinal involvement (IBD), cardiac involvement (aortitis, aortic regurgitation, pericarditis), respiratory involvement (apical fibrosis), neurologic involvement (cauda equina syndrome), and skin involvement (psoriasis).
The investigations mentioned in the text can help confirm the diagnosis of AS. X-rays of the SI joint and spine can show characteristic findings such as pseudowidening of the SI joint, squaring of the edges of vertebral bodies, and bamboo spine appearance. MRI of the spine can assess disease activity and detect cartilage changes, bone marrow edema, erosions, and subchondral bone changes. Laboratory tests such as CBC, ESR/CRP, ALP, Ca2+, SPEP, BMD, and HLA-B27 can also be helpful.
The treatment for AS includes non-pharmacological therapy to prevent fusion and improve posture and mobility. This can involve exercises, postural and deep breathing exercises, physical therapy, and smoking cessation. Pharmacological therapy includes NSAIDs as the first line of treatment for both peripheral and axial disease. Glucocorticoids may be used topically, locally, or systemically if necessary. DMARDs such as sulfasalazine and MTX can be used for peripheral arthritis. If there is an inadequate response to NSAIDs or DMARDs, anti-TNF agents can be considered. Extra-articular manifestations should
- spondylosaurus 3y agoThat's for sure better, although the "what are five symptoms of chronic inflammation" question on the homepage is still giving strange answers (so much cancer!): > Some examples of chronic inflammatory conditions that can lead to the development of cancer include solar irradiation, asbestos exposure (mesothelioma), pancreatitis, and infection. Other organs that appear to be more susceptible to the oncogenic effects of chronic inflammation include the gastrointestinal (GI) tract, prostate, and thyroid gland. Individuals who have suffered from ulcerative colitis for 10 years or more have up to a 30-fold increase in the risk of developing colon cancer. Chronic viral hepatitis caused by hepatitis B virus (HBV) or hepatitis C virus (HCV) infection also markedly increases the risk of liver cancer. These examples are mentioned in the provided text. These aren't really symptoms of inflammation so much as consequences of inflammation.
- willy_k 3y agoIsn’t that what a symptom is? A perceptible consequence of a pathology?