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您请求的操作仅限于组中的用户:==[图片:AS腰椎。jpg|框架|左| AS的x线表现]]强直性脊柱炎==强直性脊柱炎(AS)是一种炎性关节病，最常见于20多岁和30多岁的男性，估计患病率为3%。在HLA B27阳性患者的亲属中，没有骶髂炎放射学证据的脊柱性疾病可能在最初出现背痛或僵硬数年后才出现。。鉴于这些发现，彻底的病史和主观检查可能有助于早期发现AS。既往有肠易激综合征、克罗恩病、银屑病关节炎和反应性关节炎的病史见于AS患者。炎症性背痛(IBP)是与AS相关的常见症状。IBP的诊断变量包括年龄和年龄;40年，>症状发作3个月，发病隐匿，晨僵持续至少30分钟，运动后改善。如果满足5项标准中的4项，这些变量的敏感性为0.95，特异性为0.85 。 Specifically, patients with AS may complain of pain and stiffness longer than 3 months, morning stiffness lasting at least 30 minutes, no improvement of back pain with rest, awakening in the second half of the night because of back pain, and alternating buttock pain. If 3 of these 4 criteria are met then there is a (+) LR of 12.4 of AS being present. See Table 1. In addition, Gran, J. et al.17 reported 5 questions with diagnostic value: age < 40 years old, morning stiffness, improvement of symptoms with exercise, a gradual onset, and duration of symptoms > 3 months, offer small shifts in the probability of this condition being present. See Table 2. '''TABLE 1 – Rudaweit, M. et al. Inflammatory back pain in ankylosing spondylitis: a reassessment of the clinical history for application as classification and diagnostic criteria. Arthritis Rheum. 2006. 54;569-578.''' {| style="width: 354px; height: 118px" cellspacing="1" cellpadding="1" width="354" border="1" |- | | '''Sn''' | '''Sp''' | '''(+) LR''' | '''(-) LR''' |- | '''2/4 Positive''' | .70 | .81 | 3.7 | |- | '''3/4 Positive''' | .33 | .98 | 12.4 | |} '''TABLE 2 - Gran JY. et al. An epidemiological survey of the signs and symptoms of ankylosing spondylitis. Clin Rheum. 1985;4:161-9.''' {| style="width: 497px; height: 231px" cellspacing="1" cellpadding="1" width="497" border="1" |- | | '''Sn''' | '''Sp''' | '''(+) LR''' | '''(-)LR''' |- | '''Positive 4/5 Questions''' | .23 | .82 | 1.3 | .94 |- | '''> 40 years old''' | 1.0 | .07 | 1.1 | 0.0 |- | '''No relief in supine''' | .80 | .07 | 1.6 | .41 |- | '''Morning stiffness''' | .64 | .59 | 1.6 | .41 |- | '''> 3 months of pain''' | .09 | .99 | 9.0 | .92 |} ''' ''' 回到 检索自"//m.houseofhawgs.com/Subjective_Assessment_of_the_Lumbar_Spine＂
回到 检索自"//m.houseofhawgs.com/Subjective_Assessment_of_the_Lumbar_Spine＂
