Diseases Treatment

What is this Condition

A chronic, usually progressive inflammatory disease, ankylosing spondylitis affects the spine and adjacent soft tissue. Typically, the disease begins in the lower back and progresses up the spine to the neck. Deterioration of bone and cartilage can lead to fibrous tissue formation and eventual fusion of the spine or peripheral joints.

Ankylosing spondylitis is diagnosed more often in men, but may be equally prevalent in both sexes. Diagnosis is often overlooked or missed in women, who tend to show more peripheral joint involvement.

What Causes it?

Recent evidence strongly suggests a familial tendency in ankylosing spondylitis. The presence of human leukocyte antigen B27 (found in over 90% of people with this disease) and circulating immune complexes suggests immunologic activity.

What are its Symptoms?

The first is intermittent low back pain that’s usually most severe in the morning or after inactivity. Other symptoms depend on the disease stage and may include:

• stiffness and limited motion of the lumbar spine

• pain and limited chest expansion caused by involvement of the costovertebral joints

• arthritis involving shoulders, hips, and knees

• kyphosis (curvature of the spine) in advanced stages, caused by chronic stooping to relieve symptoms

• hip deformity with limited range of motion

• tenderness over the inflammation site

• mild fatigue, fever, loss of appetite or weight; occasional inflammation of the iris; aortic regurgitation and enlarged heart; upper lobe pulmonary fibrosis (which mimics tuberculosis).

These symptoms progress unpredictably, and the disease can disappear temporarily or permanently or flare up at any stage.

How is it Diagnosed?

Typical symptoms, family history, and blood tests showing human leukocyte antigen B27 strongly suggest ankylosing spondylitis. However, confirmation requires additional blood tests as well as X-rays.

How is it Treated?

No treatment reliably stops progression of this disease, so management aims to delay further deformity by enforcing good posture, stretching and deep-breathing exercises and, in some people, wearing braces and lightweight supports.

Anti-inflammatory pain relievers, such as aspirin, lndocin, Azulfidine, and Clinoril, control pain and inflammation.

Severe hip involvement usually requires hip replacement surgery . Severe spinal involvement may require a spinal wedge osteotomy (surgical cutting of bone) to separate and reposition the vertebrae. This surgery is performed only on selected people because of the risk of spinal cord damage and the long convalescence involved.