Ankylosing Spondylitis

Ankylosing Spondylitis

Ankylosing Spondylitis (AS) is a chronic inflammatory disease of unknown etiology characterized by inflammation of spinal joints and adjacent structures. This inflammation leads to progressive fusion of the spine. The characteristic radiographic change in AS is the “bamboo spine”.
Peripheral joints are less affected although the hips and shoulders may become involved in 30% of cases. Also, inflammation of organs, such as the eye and heart, may occur. Males appear to be affected more than females. Age of onset ranges from adolescence to age 25 and peaks around 28 years. Approximately 15% of adult American and European cases have been found to have a childhood onset.Disease susceptibility is strongly linked genetically. HLA-B27 is the gene associated with most cases. A positive family history of AS can be found in 15% to 20% of cases.
Typically AS causes progressive stiffness and spinal restriction with intermittent exacerbations.

Frequently Asked Questions

What is are the initial Symptoms ?
Chronic low back pain and stiffness are typically the first symptoms. Onset is usually slow rather and patients often cannot date when symptoms first began, or precisely localize the areas affected. They can present with prominent morning stiffness and pain and thought the day with periods of inactivity which improves with exercise. The earliest abnormality is usually tenderness in the sacroiliac joints.
How is the diagnosis made?
Diagnosis is made through careful detailed hipster physical exam Laboratory testing for HLA b27 positivity examining Joints and Diagnostic US testing for inflammatory and radiographic damage.
How is this treated?
The major aims of management include:

  • -Prompt recognition and management of articular and extra-articular complications be identified and managed.
  • Pharmacological relief of pain and stiffness through Biologic treatment physical therapy and lifestyle modification aimed at preserving spinal mobility or at least preventing spinal deformity and disability.
  • Treatments with non-steroidal anti-inflammatory medicines may reduce spinal stiffness. For moderate to severe cases early treatment with biologic treatment has shown to limit disease progression.