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 Low back pain  

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A 15 years old boy,come to hospital with low back pain for 3 years.
He complaint pain on both hips and norturnal stiffness improve with exercise.
What is the pathogenesis hypothesis in this patient's disease?


Path hypothesis includes molecular mimcry due to some viral infection in patients with HLA-B-27. AB formed against joint space material with release of cytokines, inflamation, repair and fibrosis. Eventually leading to fusion of involved bones.
Bamboo spine is the sign of advanced disease.


grin COrrect! the patient has ankylosing spondylitis
By the way when you say "joint space" do u include the pathlogy usually occur at "enthesis" the end when joint ligament


As my post above I didn't mean to bluff !
But I really don't know that does enthesis relevent joint space


Yes, enthesitis with chronic inflammation.
Cells involved include CD4+ and CD8+ T lymphocytes and macrophages. Cytokines, involved include TNF-alpha and TGF-beta, leading to fibrosis and ossification at sites of enthesitis.

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