Ankylosing Spondylitis

“Ankylosis” -Fusion “Spondylitis”-Inflammation of the spine
Ankylosing Spondylitis (AS) is an autoimmune inflammatory arthritis which most commonly affects young male with age of less than 40-45 yrs.
It is one of the autoimmune condition which mostly affects males rather than female.
Autoimmune disease means body’s own immune system getting dysregulated and attacks self-healthy cells and joints.
Patients with ankylosing spondylitis complaints stiffness and pain from the neck to the lower back
As causes Spine to become inflexible or rigid like bamboo spine
Ankylosing Spondylitis is also termed as Spondyloarthropathy.

As is a subgroup of Seronegative Spondyloarthropathy, which also includes psoriatic arthritis, reactive arthritis and IBD associated arthritis.

Ankylosing Spondylitis(AS) is an autoimmune disease and occurs when the body’s own immune system attacks its own joints and sometime other healthy cells such as eye.
Because of fight between immune system and joints it results in joint pain and swelling, stiffness in the spine.
Genetics play a strong role in Ankylosing Spondylitis(AS)
90% of AS have HLA B27 positive but alone positivity of HLA B27 doesn't mean that he will develop AS.
Mere presence of HLA B27 positive increases the chance of developing AS in future
Now days researchers giving more emphasis in role of dietary or environmental factor as causative agent.
Inflammation starts at the sacroiliac joint.

Absence of HLA-B27 doesn’t guarantee that you will not suffer from Ankylosing Spondylitis.

Note
If you don’t have the gene HLA-B27 that doesn’t mean that you will not suffer from Ankylosing Spondylitis. However, presence of HLA-B27 with symptoms of low back pain in the early morning almost guarantees AS.

Ankylosing Spondylitis can be painful as it affects the spines, and leads to huge discomfort by affecting posture and mobility.
The following are the signs and symptoms associated with AS
Complaints more low back pain while getting up from the bed
Stiffness in the low back more than 30 minutes in the early morning
The low back pain is worse in the morning and gets better with time, with certain exercises.
The initial signs of the disease can be seen during the age 18-30 Individuals, where the individuals may experience a stiff back.
Ankylosing Spondylitis can affect thoracic and cervical spine leading to restriction of movement of neck

Along with low back pain patients also complains heel pain, not able to put the foot over the floor while getting up from the signs and symptoms associated with AS.
It can affect other joints such as shoulder, hip, knee and ankle joints leading to swelling and pain.
Individuals with AS may also experience Inflammation in eye (uveitis) leading to pain and reddish discoloration of eye.
Patients with Uveitis have difficulty in vision and pain needs urgent treatment.
The disease is chronic and has to be dealt with for a longer period of time.
Individuals with AS have a higher chance of developing heart diseases.

A Rheumatologist is the best person to treat spondylitis.
After a detail history and clinical examination Ankylosing Spondylitis can be diagnosed. Sometimes blood tests and radiologic tests are needed to diagnose AS

Blood Tests
The blood tests give an idea about inflammation.
 Complete Blood Count
 S Creatinine for kidney function status
 Liver function test
 ESR/CRP
 HLA B27-PCR or Flow cytometer

X-Rays & MRI
X-Rays of pelvis, spine, hips and other joints help in diagnosis of AS.
Similarly, Magnetic Resonance Imaging (MRI) of sacroiliac joint can be done in special cases, where X-Rays don’t provide sufficient information.
MRI sacroiliac joint sometimes helps in diagnosing NON RADIOGRAPHIC ANKYLOSING SPONDYLITIS (Nr-AS)

Ankylosing doesn’t affect pregnancy – However, patients with AS have to bear with the following concerns
Medications
Before taking medications for AS during pregnancy, it is strictly advisable to consult the doctor.
Delivery
Women who experience inflammation in hips, pelvis etc. - Can have a difficult time during delivery. Thus, most women with Ankylosing Spondylitis undergo caesarean. The spinal fusion often makes epidural difficult – Hence, pain control methods, or general anesthesia are used under special circumstances.