Ankylosing Spondylitis is one of the most common forms of arthritis affecting approximately 0.5% of the population. It affects men more frequently than females by a ratio of approximately 2.4-5:1. The disease is categorized as "spondyloarthropathy" ... a type of arthritis that affects the spine preference. It usually begins in the sacroiliac joint membership of the joints of the pelvis, the lower back and spreads upward to the rest of the spine combined. Peak age of onset is 15 to 30Years.
Typically, a patient will complain of stiffness in the lower back or neck, or both, that is worse with rest and better with activity. Often a young person is doing sports as a way of pain relief they have to! Stiffness during the day due to inactivity is also common. Other joints affected are the hip, knee, wrist, shoulder, elbow and ankle joints. Typically, patients will not only have common symptoms, but it will also enthesopathy ... Meaning inflammationPoints where tendons connect to bones. Fatigue is a very common symptom. Occasionally, slight fever, anorexia and weight loss can be observed.
Patients sometimes present with extra-articular (outside the joint) symptoms. Examples are an inflammation of the eye, lung, and in rare cases, the heart. The most common extra-articular symptom is ocular inflammation, which occurs in approximately 40% of patients, and must be diagnosed and treated aggressively. Blindness is a dreadedComplication.
The physical examination will show restriction of movement in the lower back. Chest expansion is also able for many patients with AS are limited limited ability to expand their lungs through the involvement of the thoracic spine further.
Occasionally, women with AS have more symptoms in the neck, as the lower back.
Laboratory tests will show abnormalities that indicate the presence of inflammation. Patients with AS also have the genetic marker HLA B27 in approximately90% of cases.
Imaging studies such as magnetic resonance imaging shows the presence of inflammation in the sacroiliac joint. Inflammation of the tendons to various affected joints will also be apparent.
Treatment goals consist of alleviating pain and stiffness as well as maintaining the function.
A comprehensive program consists of a combination of anti-inflammatory drugs to deal with symptoms and disease-modifying therapy to help slow theprogression. Examples of anti-inflammatory drugs are drugs such as ibuprofen (Motrin), naproxen (Naprosys), nabumetone (Relafen), etodolac (Lodine), meloxicam (Mobic) and celecoxib (Celebrex). Disease-modifying drugs, which are extensively used for this condition, are sulfasalazine (azulfidine) and methotrexate. Biological therapies such as etanercept (Enbrel), adalimumab (Humnira) and infliximab (Remcade) are of particular importance for inducing remission. A sound program of physical therapywith range of motion, help is also required.
Recommended for patients with suspected eye disease, close supervision by an experienced ophthalmologist.
People with very advanced disease may suffer complications such as compression of the spinal cord (cauda equina syndrome), and fractures of the neck. Particular care should be exercised in preparing patients for surgery with AS. Intubation (using an air hose leading into the airways) for general anesthesiathe risk of inadvertent vertebral fracture.
The operation is in advanced cases that have not responded to medical therapy, and completeness.
The clinical course and prognosis are very different and also depends on the rapidity of diagnosis and the effectiveness of therapy.
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