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SPONDYLITIS
WHAT & HOW
IN
AYURVEDA?
* Dr.Gulwinder Singh Dehal
** Dr. Ravishankar Shenoy M.D (Ayu)
INTRODUCTION
• A.S. an inflammatory disorder of
unknown cause primarily affects the axial skeletal,
peripheral joints and also involves the extra articular
structures.
• The disease usually begins in 2nd or 3rd decade of life,
its prevalence being approximately 3 times more in
men than in women.
• ETIOPATHOLOGY
Describing the pathology of the disease with regard to
sacroiliitis, the most common manifestation of A.S.,
shows erosion of the iliac cartilages followed by its
replacement with fibro cartilage regeneration
termination into ossification.
•
CLINICAL
Insidious onset
FEATURE
• Dull pain felt deep at lower lumber/ Gluteal region
• Low back morning stiffness for few hours’ that improves with
activity and returns following period of inactivity
• Pain with few months become persistent and bilateral that later
becomes intermittent
• Presence of Nocturnal exacerbation of pain
• Bony tenderness may or may not exist
• Neck pain relatively a late manifestation
• Constitutional symptom like Fatigue, Anorexia, Fever, weight
Loss, Night sweat
• Loss of spinal mobility- limiting- ant, lat. Flexion and extension
chest expansion
• Lumber lordosis obliterated with atrophy of buttocks
• Accentuated thoracic kyphosis
• Forward stooping of neck
• Flexion contractures of hip compensated by flexion of knee.
DIAGNOSTIC CRITERIA
(New York Criteria 1984)
1. H/O inflammatory back pain
2. Limitation of motion of lumbar spine in
saggital and frontal plane
3. Limited chest expansion related to standard
value for age and sex
4. Definite radiographic sacroiliitis
Under this criteria presence of
radiographic sacroiliitis plus any of above
criteria is sufficient for diagnosis
Short Description of the Case
A male, unmarried patient aged 28 yrs, presented with complaints of pain and stiffness in the low
back 4-5 yrs and back of neck – 6 months with no association of fever/sore throat what so ever.
His previous Blood reports revealed a normal range of Hb, TC, DC. E.S.R. was high (70mm/1st
hr) and R.A factor was negative.
The physician advised an X-ray which revealed Ant. Spinal ligament calcification over lower
lumbar spines.
Hb -14.4 gm%
TLC – 8,350 cells/mm
DLC – N 65%; L-28%; E-06%; M-01%
ESR-68mm/1st hr
R.A factor- +ve (64U/ml)
Blood urea – 22mg/dl (WNL)
F.B.S – 100 mg/dl
Anaha 4 1 75.0