0521779407-19 CUNY1086/Karliner 0 521 77940 7 June 6, 2007 17:50
Spine & Spinal Cord Injury Spondyloarthropathies 1361■Sphincters may be impaired, typically w/urinary and fecal retention
■Complete cord injury: no motor or sensory function preserved below
lesion level
tests
■Stabilize spine before any imaging studies
■Lateral film of neck on all pts w/head, cervical or multiple injuries
■MRI to visualize cord & soft tissues
differential diagnosis
■Imaging studies will suggest nature & extent of cord injury.
management
■Maintain spinal stability
■Assess adequacy of ventilation; support may be required after cervi-
cal or upper thoracic injuries
■Analgesia as needed
■Assess for presence & severity of cord injury
■Methylprednisolone for 24–48 hr if cord injury has occurred
■Care of skin, bladder, bowels
■Physical therapy to maintain joint mobility & muscle function
specific therapy
■Subdural or epidural hematomas may require evacuation
■No specific therapy otherwise except as indicated for mgt as above
follow-up
■Depends on nature & severity of injury
complications and prognosis
■Prognosis for recovery is better w/incomplete than complete lesionsSPONDYLOARTHROPATHIES
DAVID TAK YAN YU, MD
history & physical
Classification
■Ankylosing spondylitis (the prototype)
■Undifferentiated spondyloarthropathy
■Reactive arthritis: preceded within 1 month by urethritis, cervicitis or
acute diarrhea caused by Chlamydia, Yersinia, Shigella, Salmonella
& Campylobacter