Assessment of patients with ankylosing spondylitis
After diagnosing ankylosing spondylitis, we do not simply start a treatment plan. Mere diagnosis is not enough. We need to make an assessment of the disease first.
How do we make an assessment for patients with ankylosing spondylitis?
We need to answer 3 questions:
What are those 3 questions? and how do they affect or dictate treatment?
Question number 1:
What is actually affected by the disease?
Is it the neck and back mainly or the joints of the ankles and knees or is it the eye, an inflammation we call iritis or is it the colon, an inflammation we call colitis? Or do we have a combination of them: like spine and colon or spine and eye inflammation for example? Our management decisions are dictated and decided by which of these organs or regions of the body are affected
Question number 2:
How active is the disease?
Whether the disease is affecting the spine or the eye or the colon, a high level of activity means we will need more intensive treatment and vice versa.
Question number 3:
How severe is the disease?
Now apart from how active is this disease, another important question is how severe is this disease. Does it tend to be an aggressive disease with troublesome irreversible affections in the systems of the body or is it a less aggressive one that does not seem to be so troublesome. This will also play an important role in our treatment decisions.
How do we answer those 3 questions in the clinic?
By obtaining from our patient a focused and detailed history, by examining the patient and by doing the needed investigations and also by making the needed referrals to other specialties if needed. This includes a referral to an ophthalmologist or to a gastroenterologist sometimes. Sometimes we combine data from history and examination and labs into tools that have scores that help with the assessment like what we call the BASDIA and the ASDAS scores that doctor use in their clinics.
---------------------------------
This post was prepared and published by Dr. Hatem Eleishi. Dr. Hatem Eleishi is a professor of rheumatology at Cairo university (Egypt) and is especially dedicated to supporting arthritis patients with online educational videos and articles about arthritis causes and treatment. He also runs a rheumatology clinic in Cairo and a center for www.tabibakom.com/en that, in addition to providing online rheumatology consultations, also provides online medical consultations in several different medical specialties by expert consultants from Egypt, Canada and the United States.
---------------------------
If you are interested in receiving the links of Dr. Hatem's videos to patients on your WhatsApp, kindly click here
---------------------------
To check the library of you tube videos of Dr. Hatem for patients, kindly click here
---------------------------
To watch the educational videos of Dr. Hatem on his you tube (Dr. Hatem Eleishi Arthritis channel), kindly click here