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Ankylosing spondylitis (AS) is a chronic, progressive inflammatory arthritis primarily affecting spine and sacroiliac joints, causing eventual fusion of the spine. Complete fusion results in a complete rigidity of the spine, a condition known as bamboo spine.
AS is characterised as a spondyloarthropathy (SpA).
Signs and symptoms
The typical patient is a young man of 15-30 years old (although women are also affected) with pain and stiffness in the spine. It is also associated with iridocyclitis (anterior uveitis), ulcerative colitis, psoriasis and Reiter's disease, through HLA-B27 (see below).
Organs affected by AS, other than the axial spine, are the hips, heart, heels, and other areas (peripheral).
Diagnosis
The diagnosis is by X-ray studies of the spine, which show characteristic spinal changes and sacroiliitis. A normal X-ray does not exclude the disease.
HLA-B27 is occasionally used, but does not distinguish AS from other diseases and is therefore not of real diagnostic value.
Epidemiology
In the USA, the prevalence is 0.25%, but as it is a chronic condition, the number of new cases (incidence) is fairly low.
The sex ratio is 3:1 for men:women.
Therapy
Physical therapy and exercise, along with medication, are at the heart of therapy for ankylosating spondylitis.
Medications used are:
Prognosis
AS can range from mild to progressively debilitating, and from medically controlled to refractive.
Pathophysiology
AS is a systemic rheumatic disease, and about 90% of the patients are HLA-B27 positive. HLA-DR and IL1ra are also implicated in Ankylosing Spondylitis.
See also
- NASC, the AS patients' federation
- NIAMS, the National Institute of Arthritis and Musculoskeletal and Skin Diseases
External links
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