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.