Schober set for the diagnosis of ankylosing spondylitis
The Schober test is a useful test for lumbar vertebral flexion or the ability to bend forward. In this test, which is used to determine the amount of vertebral movement in ankylosing spondylitis, the patient stands upright (with the heels together) and two marks are placed on the vertebrae, one at the vertebral junction. Lumbar and sacral (marked by a horizontal line between the posterior-upper iliac spines) and another 10 cm above it. The patient is then bent forward with maximum force (with the knees fully extended and straightened) and the distance between the two marks measured. This distance increases by 5 cm or more if the lumbar vertebrae move normally and by less than 4 cm if the lumbar vertebrae are able to move.
Measuring chest expansion
Chest expansion is measured as the difference between the maximum tail and the maximum forced exhalation in the fourth intercostal space in men or just below the breasts in women while the patient’s hands are on his head or right. They are behind it. The normal rate of chest opening is 5 cm or more.
Lateral spinal flexion test
In the lateral flexion test, the distance the middle finger of the hand goes down the path of the foot is measured as the patient bends to one side as far as possible. Its normal size is more than 10 cm.
There is usually limitation or pain when moving the pelvic or shoulder joints. It should be noted that in the early stages of ankylosing spondylitis, in mild cases, the symptoms may be mild and nonspecific and physical examination may not reveal abnormalities.
The course of the disease varies greatly, from a person with mild joint dryness and normal radiographs to a patient with fully fused vertebrae and severe bilateral pelvic arthritis (with severe peripheral arthritis and extra-articular symptoms). , Is different.
The patient’s physical condition undergoes certain changes, including loss of lumbar lordosis, atrophy of the buttocks, and exacerbation of kyphosis (hump) of the thoracic vertebrae. Bending of the neck forward or contraction may be caused by bending the pelvic joint, which is compensated for by bending the knees.
The progression of ankylosing spondylitis can be assessed clinically by reducing the patient’s height, limiting chest opening and vertebral flexion (lumbar flexion or flexion), and measuring back-to-wall distance. Sometimes we encounter patients with severe deformities who have never had significant symptoms.
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