Understanding Ankylosing Spondylitis: Symptoms, Diagnosis & Treatment
Ankylosing Spondylitis is a chronic inflammatory arthritis affecting the spine and sacroiliac joints, leading to bony fusion. Learn about its clinical features, causes, and management options.
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Ankylosing Ankylosing spondylosis spondylosis Dr.Apurva Dr.Apurva ajane Assistant professor Assistant professor Practice of medicine Practice of medicine ajane ( (bhuti bhuti) )
Definition Definition Ankylosing spondylitis is characterized by a chronic inflammatory arthritis predominantly affecting sacroiliac joints and spine which can progress to bony fusion of the spine.
It is also known as Bechterew disease is a group of diseases called as seronegative spondyloarthropathies. Ankylosing spondylitis also affects other parts of the body such as eyes and blood vessels.
Aetiolgy Aetiolgy More common in men than in women Genetic factors-HLA-B27 and HLA-DR1 confer susceptibility to the spondyloarthropathies. Peak onset in second & third decades of life. Environmental triggers remain unknown.
Clinical features Clinical features These are the symptoms suggestive of ankylosing spondylitis: The onset is usually insidious Recurring episodes of low back pain and marked stiffness. Age at onset is <40 yrs. Persistence of symptoms for >3 months. Improvement with exercise. Radiating pain to the buttocks. Pain is more in early morning and after inactivity and relieved by movement.
Sacroiliac joints and spine:-Early sign is evidence of sacroiliac joint arthritis. -Examination of spine may reveal muscle spasm and loss of normal lordosis. -Slow forward bending of spine. Peripheral joint involvement-Inflammatory disease of hip and shoulder may produce progressive disability. Enthesopathic features include plantar fasciitis, costochondritis and Achilles tendinitis. Extraarticular manifestations include acute anterior uveitis, IBD ,aortic insufficiency.
Investigations Investigations 1.Radiology :- X Ray or CT Scan : -Early changes in lumbar spine is manifested as squaring of the superior and inferior margins of vertebral body. -Later changes results in Bamboo spine. MRI : -Erosion or Narrowing of the joint space (early). -Joint fusion (late stage).
Ankylosing spondylitis spine Xray Normal spine X ray
2.Genetic testing :-For HLA-B27 is present in 95%.. 3.Blood investigations:-ESR is elevated.
Management Management Physiotherapy is of major use in long term management.
