Ankylosing spondylitis, also referred to
as rheumatic spondylitis and ankylosing spondylitis, is
a progressive, systemic, rheumatic disease which causes
inflammation and pain in the tendons, joints and
ligaments. Ankylosing spondylitis most often affects the
spine but it may also affect other areas such as the
heart, lungs, bowl and eyes.
Ankylosing (rheumatic) spondylitis is a
condition in which inflammation occurs in the place
where tendons and ligaments meet the bones followed by
bone loss in the area of inflammation, and new bone
formation which causes the vertebrae to merge together
causing pain, stiffness and loss of movement. This
rheumatic spondylitis usually starts affecting the
pelvis followed by the lower back, chest wall and neck.
However, these areas can be affected at
different times or not at all. Sometimes ankylosing
spondylitis is associated with the scaly red skin
disease called psoriasis. It is also may accompany
diseases such as inflammatory bowel disease or Reiter’s
syndrome. It is also a systemic disease which may affect
the whole body, causing fever, appetite loss, fatigue
and damage to organs such as the lungs, heart, eyes and
joints.
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The time when ankylosing spondylitis is
most likely to first appear is when the patient is in
his late teens or early twenties. The average age that a
person develops ankylosing spondylitis is age 24. Three
times as many men get ankylosing spondylitis than women.
In children, ankylosing spondylitis most often affects
the buttocks, hips, knees, feet and ankles. Rarely do
children with ankylosing spondylitis develop back
problems. However, it is common that they develop hip
disease which may require surgery to replace the hip.
Ankylosing spondylitis usually does not
occur in children until they are over age 11. When
ankylosing spondylitis affects men, it most often
strikes the spine and pelvis but sometimes strikes the
shoulders, feet or chest wall. When ankylosing
spondylitis affects women, it most often strikes the
pelvis, knees, hips, ankles and wrists. The spine is not
often affected by ankylosing spondylitis in women
People who have Crohn’s disease,
ulcerative colitis or other inflammatory bowel diseases
are more likely to develop ankylosing spondylitis.
There may be a heredity link to the
development of ankylosing spondylitis. Most people with
ankylosing spondylitis have the genetic marker called
HLA-B27. This is only part of the story, however,
because about 80 percent of those who have HLA-B27 never
develop ankylosing spondylitis. It is not known what
causes some people with HLA-B27 to get ankylosing
spondylitis and others will not. About one out of five
people with ankylosing spondylitis have a family member
with the disease.
The symptoms of ankylosing spondylitis
include a gradual development of back pain and stiffness
that gets worse over a few weeks or months and is worse
in the morning and improves over the course of the day
or after exercise, symptoms that last for more than
three months, extreme tiredness, and unexplained weight
loss at the onset of the disease, fever and night
sweats. When ankylosing spondylitis affects the eyes
(this happens in one out of four patients), the symptoms
are red, painful eyes that are light sensitive.
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Rheumatic spondylitis progresses over
time as bones gradually grow together from the
inflammation and healing processes of the diseases. Bone
fusion causes a loss of movement and stiffness until the
entire spine becomes inflexible. The disease may also
progress to cause a difficulty in expanding the chest
while breathing. Ankylosing spondylitis may progress to
the hips, knees, ankles and shoulders, making mobility
difficult and painful. Mobility may be lost entirely.
When ankylosing spondylitis affects the heels, the
patient may have trouble standing or walking.
When ankylosing spondylitis has been
progressing for many years, heart and lung problems may
also develop. One particularly serious problem caused by
ankylosing spondylitis is enlargement of the aorta.
The treatment for ankylosing spondylitis
includes surgery, non-steroidal anti-inflammatory drugs
(NSAIDs),
pain killers, body posture, and exercise. Treatment will
be individualized for the patient depending on the
severity of the disease and the symptoms present.
Surgery is used in ankylosing spondylitis patients when
the hip needs replacement. Only about six percent of
patients with ankylosing spondylitis need this surgery,
however. In extremely rare cases, surgery to straighten
the spine may be necessary.
Non-steroidal anti-inflammatory drugs are
used by over 80 percent of patients with ankylosing
spondylitis. NSAIDs reduce inflammation and give the
patient respite from the pain. Some people with
ankylosing spondylitis prefer to simply take pain
killers.
Ankylosing spondylitis can often be
controlled with exercise and proper posture.
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