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Fixed texting posture: An alternative denomination for the Skier’s posture in patients with Ankylosing Spondylitis
Camila Costa Silva1, Marcus Luca Maciel2, Fabricio Souza Neves3
1Undergraduate Student, Medicine Course, Health Sciences Center, Federal University of Santa Catarina (UFSC), Florianopolis, Santa Catarina, Brazil
2Graduate student, Rheumatology Residence, University Hospital Prof. PolydoroErnani de São Thiago, Federal University of Santa Catarina (UFSC), Florianopolis, Santa Catarina, Brazil
3Professor, Rheumatology Unit, Internal Medicine Department, Health Sciences Center, Federal University of Santa Catarina (UFSC), Florianopolis, Santa Catarina, Brazil

Article ID: 100012Z14CS2018
doi: 10.5348/100012Z14CS2018CL

Corresponding Author:
Fabricio Souza Neves,
Departamento de ClínicaMédica – Hospital Universitário, 3º andar,
Rua Maria Flora Pausewang S/N. Campus Universitário da UFSC, Trindade,
Florianópolis, Santa Catarina, Brazil, 88036-800

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How to cite this article
Silva CC, Maciel ML, Neves FS. Fixed texting posture: An alternative denomination for the Skier’s posture in patients with Ankylosing Spondylitis. J Case Rep Images Orthop Rheum 2018;3:100012Z14CS2018.


CASE REPORT

Ankylosing Spondylitis (AS) is a form of arthritis that affects the spine and can lead to neck abnormalities. Posture with fixed neck flexion is usually observed in long standing cases of AS. This type of neck abnormality in AS cases is known as skier’s posture [1]. A similar position is seen in healthy people when they are texting on mobile phones. In Figure 1A, a patient with long standing AS is texting using a cell phone. In Figure 1B, the same patient is looking ahead. In both situations, the posture of the patient with excessive neck flexion remains unaltered. Figure 1C shows a healthy person with excessive neck flexion during texting and in Figure 1D, he has a normal posture. The skier’s posture in long standing AS (Figure 1B) is similar to the posture that healthy people assume while texting (Figure 1C).

Keywords: Ankylosing spondylitis, Medical Education, Posture, Spondylarthritis



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Figure 1: : (A) Patient with ankylosing spondylitis (AS) with excessive neck flexion during texting; (B) Patient with AS remains continuously with the same posture with excessive neck flexion: “fixed texting posture” (skier’s posture); (C) A healthy person with excessive neck flexion during texting: “texting posture”; (D) A healthy person reassumes a normal posture after texting.



DISCUSSION

The excessive neck flexion feature in AS patients has been classically described as the “skier’s posture” [1]. Skiing is a sport whose practice is restricted to a few regions of the world. Thus, we believe this term is problematic for educational purposes in many countries, since only few medical students, physicians and AS patients worldwide have experienced or even observed skiing. In contrast, billions of people in every country are accustomed to texting (the activity of sending or receiving text messages via mobile electronic devices). Texting activity has been reported to induce in healthy people a posture with excessive flexion of the neck [2], which is quite similar to the skier´s posture.


CONCLUSION

We suggest that the “skier’s posture” in AS patients should alternatively be termed “fixed texting posture”, in analogy with the posture with excessive neck flexion that appears in healthy people only during the texting activity.


REFERENCES
  1. Grubisic F, Jajic Z, Alegic-Karin A, Boric I, Jajic I. Advanced clinical and radiological features of ankylosing spondylitis: Relation to gender, onset of first symptoms and disease duration. Coll Antropol 2015 Dec;39(4):927–34.   [PubMed]    Back to citation no. 1
  2. Hansraj KK. Assessment of stresses in the cervical spine caused by posture and position of the head. Surg Technol Int 2014 Nov;25:277–9.   [PubMed]    Back to citation no. 2

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Author Contributions
Camila Costa Silva – Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published
Marcus Luca Maciel – Acquisition of data, Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Fabricio Souza Neves – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of Submission
The corresponding author is the guarantor of submission.
Source of Support
None
Consent Statement
Written informed consent was obtained from the patient for publication of this clinical image.
Conflict of Interest
Author declares no conflict of interest.
Copyright
© 2018 Camila Costa Silva et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.