Patient Education

ANKYLOSING SPONDYLITIS

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.

  • Mostly affects young male with age of less than 45 yrs of age
  • 90% of AS individuals have HLA B27 (a gene) positivity
  • You have more chance to get AS if your any family member is suffering from AS.

  • 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.