Page 812 - Clinical Immunology_ Principles and Practice ( PDFDrive )

CHaPtEr 57 Spondyloarthritis 783

A

B C
FiG 57.6 (A) Magnetic resonance imaging (MRI) of the sacroiliac joints, showing areas of marrow
edema (indicated by arrows) on STIR sequences. (B) Lateral spine, showing enhancement of
the insertion of the annulus fibrosis on the disk (arrowheads) and subchondral bone (arrows).
(C) Involvement of the subchondral bone of the apophyseal joints.

Patient Education and Physiotherapy
outcome in juvenile-onset AS is different from that in adult-onset
disease. A great deal of educational information is available for patients
(http://www.spondylitis.org and http://www.arthritis.org). Unsu-
TREATMENT pervised recreational exercise improves pain and stiffness, and
back exercise improves pain and function in patients with AS and
Recent guidelines for treatment of SpA have been put forth by other types of SpA, but these effects differ with disease duration.
the American College of Rheumatology and the European League Health status is improved when patients perform recreational
against Rheumatism based on current literature and clinical trials exercise at least 30 minutes per day and back exercises at least
(Table 57.7). 38,39 5 days per week.