What is Ankylosing Spondylitis?
Ankylosing Spondylitis or Spondylitis (AS) is a rheumatic disease that causes inflammation of the joints of the spine and the sacroiliac. It may manifest as isolated episodes of low back pain or as more serious affecting the whole spine and peripheral joints causing pain in the spine and joints spinal stiffness loss of mobility and progressive deformity. Sometimes it may be accompanied by extra-articular manifestations such as inflammation of the eyes or the heart valves.
The AS belongs to a group of diseases affecting the spine called spondyloarthropathies. In this group besides the AS include Reiter’s syndrome some forms of psoriatic arthropathy and arthropathy associated with inflammatory bowel disease.
What Is Your Cause?
The cause of ankylosing spondylitis is unknown but all share a spondyloarthropathies common genetic marker HLAB27 which appears in most affected individuals. In some cases the disease occurs in these predisposed patients after exposure to an intestinal infection or urinary tract.
Impact On Population
Subsequent to approximately 1 per 1000 inhabitants. Typically begins in adolescence or young adulthood and its incidence is higher in men than in women introducing them moreover a milder illness. Its incidence varies in different racial groups.
Diagnosis
The basis for the diagnosis of ankylosing spondylitis is the symptoms reported by the patient and the doctor observed abnormalities on physical examination. Often the diagnosis is delayed because symptoms are attributed the disease to other more common processes that affect the lumbar region.
The night pain and loss of mobility in the lumbar region are common and early manifestation of AD. Although the majority of cases symptoms begin in the lumbar and sacroiliac areas are also affected segments of the cervical and thoracic spine. Arthritis can also affect large peripheral joints (shoulders and hips) and toe and heel.
Some patients have eye inflammation in the most severe cases can be seen involvement of the heart valves. Sometimes ankylosing spondylitis may precede the development of inflammatory bowel disease and some patients have high fever fatigue weight loss and anemia.
Other visceral or bone disease can mimic the Spondyloarthropathies and must be distinguished from them: the analytical evaluation can demonstrate inflammation anemia or HLAB27 positivity. X-rays and bone scans may show characteristic changes.
Treatment
The severity of joint involvement and the degree of systemic manifestations vary greatly from one individual to another. The early and accurate diagnosis and proper treatment can minimize pain and functional disability.
Medical treatment is based on the NSAIDs. Indomethacin is the most effective of them. Sulfasalazine may be beneficial in patients with serious illness. Arthritis of peripheral joints may respond to methotrexate.
The rehabilitation treatment is essential. Proper positioning during sleep and walking along with exercises for abdominal and paraspinal muscles help prevent deformities. Should be scheduled and EXERCISES maintain joint flexibility and breathing exercises to help maintain lung capacity. Even with optimal treatment some patients develop stiffness or ankylosis of the spine.
It is crucial for continuing treatment. Ankylosing Spondylitis is a chronic problem that persists throughout life and some patients often stop using the result of postural deformities and permanent loss of mobility.
The Rheumatologist’s Role in the Treatment of Ankylosing Spondylitis
The rheumatologist is specially trained to diagnose and treat AD can serve as an educator of patients and other physicians on this disease. Rheumatologists are ahead in the basic and clinical research on this disease and they depend on improved understanding and treatment of it.