ANKYLOSING SPONDYLITIS

What is Ankylosing Spondylitis? Spondylitis involves inflammation of one or more vertebrae. Ankylosing spondylitis is a chronic inflammatory disease that affects the joints between the vertebrae of the spine, and the joints between the spine and the pelvis. It eventually causes the affected vertebrae to fuse or grow together.

What are the causes of Ankylosing Spondylitis?

The specific cause for this disease is unknown, but genetic factors seem to play a role. The disease starts with intermittent hip and/or lower back pain that is worse at night or after inactivity. Back pain begins in the sacroiliac joint (joint between the pelvis and the spine) and may progress to include the lumbosacral spine and the thoracic spine (chest portion of the spine). Pain may be eased by assuming a bent posture. Limited expansion of the chest occurs because of the involvement of the joints between the ribs. The symptoms may worsen, go into remission, or stop at any stage.

With progressive disease, deterioration of bone and cartilage can lead to fusion in the spine or peripheral joints affecting mobility. It can be extremely painful and crippling. The heart, the lungs, and the eyes may also become affected. The disease most frequently begins between the ages of 20 and 40 but may begin before 10 years of age. It affects more males than females. Risk factors include a family history of ankylosing spondylitis and male gender. About 0.21% of Americans over age 15 are affected.

What are the Symptoms of Ankylosing Spondylitis?

  • low back pain that is worse at night or after inactivity
  • stiffness and limited motion in the low back
  • hip pain and stiffness
  • limited expansion of the chest
  • limited range of motion, especially involving spine and hips
  • joint pain and joint swelling in the shoulders, knees, and ankles
  • neck pain
  • heel pain
  • chronic stooping to relieve symptoms
  • fatigue
  • fever, low grade
  • loss of appetite
  • weight loss
  • eye inflammation

How is Ankylosing Spondylitis Diagnosed?

Physical examination and characteristic symptoms are indicative of limited spine motion or chest expansion.

Tests may include:

  • HLA-B27 antigen test is positive
  • A spine X-ray or pelvis X-ray shows characteristic findings
  • ESR may or may not be elevated
  • CBC may show mild anemia

What is the Treatment of Ankylosing Spondylitis?

The objective of treatment is to relieve the joint pain and to prevent, delay, or correct deformities.

Medication may include non-steroidal anti-inflammatory medications (NSAIDs) and corticosteroid therapy or medications to suppress the immune system.

Surgery may also be performed. Exercises to improve posture and breathing may also be initiated. Patient may also use devices to help with activities of daily living.

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