Ankylosing spondylitis is a chronic, inflammatory autoimmune disease that is a rare form of arthritis. It primarily affects the sacroiliac joints between the bones of the pelvis, and the axial skeleton, which includes the spinal column, ribcage, neck, and skull bones.
Ankylosing spondylitis can be difficult to diagnose because the condition develops slowly and there is no single definitive test that can confirm the diagnosis. A diagnosis of ankylosing spondylitis starts with a patient history and physical examination in which a doctor checks for inflammatory back pain and irritation of soft tissues (muscles, ligaments, tendons) where they enter the bones (enthesitis), or arthritis.
Imaging tests used to help diagnose ankylosing spondylitis may include:
- X-rays of the spine and pelvis
- Computed tomography (CT) scan
- Magnetic resonance imaging (MRI) scan
- Power Doppler ultrasonography
Blood tests used to help confirm the diagnosis of ankylosing spondylitis or rule out other conditions include:
- HLA-B27 gene
- Erythrocyte sedimentation rate (ESR)
- C-reactive protein (CRP)
What Are Symptoms of Ankylosing Spondylitis?
Pain and stiffness in the lower back and buttocks are characteristic symptoms of ankylosing spondylitis, which usually starts in late adolescence or early adulthood.
In addition to pain and stiffness, early-stage ankylosing spondylitis symptoms may include:
- General discomfort
- Loss of appetite
- Mild fever
Other symptoms of ankylosing spondylitis may include:
- Irritation of soft tissues (muscles, ligaments, tendons) where they enter the bones (enthesitis), most often in extremities
- Arthritis
- Fatigue
- Bowel inflammation
- Anemia
- Eye inflammation (uveitis or iritis)
- Blurred vision
- Painful, watery, and red eyes
- Sensitivity to bright light
- Stooped posture (advanced stage)
What Causes Ankylosing Spondylitis?
The cause of ankylosing spondylitis is unknown. A combination of genetic and environmental factors is believed to play a role.
Risk factors for ankylosing spondylitis include:
- Family history of the condition
- Smoking
In people who may have a genetic predisposition, triggers for ankylosing spondylitis may include:
- Infections
- Heavy physical activity
- Work stress
- Emotional stress
- Pregnancy
What Is the Treatment for Ankylosing Spondylitis?
Treatment for ankylosing spondylitis usually involves a combination of exercise and physical therapy, healthy lifestyle changes, and medication. Surgery may be needed in severe cases.
Physical therapy and exercise used to treat ankylosing spondylitis includes:
- Exercise
- Posture training to help prevent the spine from becoming “frozen”
Lifestyle modifications to help manage ankylosing spondylitis include:
- Safety measures to minimize accidents caused by limited mobility
- Eat a healthy diet with anti-inflammatory foods
- Don’t smoke
- Pace yourself and take breaks when needed
- Support groups
Medications used to treat ankylosing spondylitis include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain and stiffness
- Biologics may be used if NSAIDs don’t work well
- Sulfasalazine (a DMARD) and methotrexate for arthritis symptom relief
- Corticosteroid injections for swollen, painful joints
- Opioids (narcotics) to treat pain
Surgery is rarely used to treat ankylosing spondylitis and most patients will not require surgical intervention. When surgery is needed, it may include:
- Joint replacement to help with severe pain or joint damage
- Fracture stabilization
- Spinal surgery
http://emedicine.medscape.com/article/332945-overview
https://www.uptodate.com/contents/axial-spondyloarthritis-including-ankylosing-spondylitis-beyond-the-basics?search=Ankylosing%20Spondylitis&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2
https://spondylitis.org/
https://www.aarda.org/diseaseinfo/ankylosing-spondylitis/
https://www.arthritis.org/diseases/ankylosing-spondylitis
https://ankylosingspondylitis.net/spinal-surgery
https://www.nhs.uk/conditions/ankylosing-spondylitis/diagnosis/