Which of the following disorders has a strong genetic component ...

[B]

Which of the following disorders has a strong genetic component and causes loss of spinal mobility and progressive erosion of the sacroiliac joint?
 
  A. Syringomyelia
  B. Spinal stenosis
  C. Ankylosing spondylitis
  D. None of the above

Question 2

Your patient is 40-year-old baseball player who needs his yearly physical exam. He reports a 5-year history of chronic lower back pain due to spinal stenosis. Which of the following findings indicate spinal stenosis?
 
  A. Lumbar x-ray demonstrates vertebral osteophytes
  B. Positive straight leg raising sign upon physical exam
  C. Lumbar MRI shows decreased intervertebral space
  D. A and C

[DHRUVSHAH]

Answer to Question 1

ANS: C
Ankylosing spondylitis is one of the spondyloarthropathi es, which have genetic predispositions and are inflammatory disorders. Early symptoms include LBP and stiffness, which gradually become persistent and increase in severity. There is loss of spine mobility, and posture gradually changes with flexion of the neck, increased kyphosis of the thoracic region, and loss of the lumbar curve. The gene HLA-B27 is present in most patients. Radiographs show abnormality of the sacroiliac joint with progressive erosion. A CT scan is useful to identify sacroiliitis.

Answer to Question 2

ANS: D
Caused by progressive degenerative spine changes, spinal stenosis is most common at middle age or later. Spinal stenosis pain is usually worse during the day. It is aggravated by standing and relieved by rest. The pain varies from severe to mild. OA signs may be present. RAdiological findings may indicate extensive vertebral osteophytes and degenerative disk disease. An MRI or CT scan can be helpful if initial x-rays are inconclusive.