Ankylosing Spondylitis is a chronic inflammatory condition that generally manifests in young ages. Disease generally involves the joints of the body especially the joints of vertebrae in spine, Sacroiliac joints (joint between pelvis and spine) and knee joints but the disease can involve other joints of the body along with some of the body organs.

 Ankylosing Spondylitis is a chronic inflammatory condition that generally manifests in young ages. Disease generally involves the joints of the body especially the joints of vertebrae in spine, Sacroiliac joints (joint between pelvis and spine) and knee joints but the disease can involve other joints of the body along with some of the body organs.

Symptoms and signs

• Young patient of age 18-30 yrs having complain of stiffness and pain in lower part of spine
• Pain may radiate to buttocks and back of upper legs
• Male to female sex ratio is 3:1; disease has sexual preponderance towards males
• Some patients may have eye inflammation typically white of eye (iridocyclitis) causing eye pain and in later stages can also lead to photophobia
• In later stage if fusion of vertebrae occurs it can lead to Bamboo spine, a condition in which spine becomes completely rigid
• Pain and stiffness increases during rest periods and subsides with an increase in physical activity
• Pain in various joints like knee joint, hips and shoulder etc.
• Constant fatigue
• Weight loss
• Loss of apetite
• Lower back stiffness
• Lower back pain
• Anemia
• Fever

Causes

Exact cause of the disease Ankylosing Spondylitis still remains unknown but various genetic and environmental factors are suspected to have some relationship with the disease process. It has been observed that the patients who have HLA -B27 gene can develop the disease

Investigation and tests

• Combined with clinical examination plain X-ray films are useful in making a diagnosis of Ankylosing Spondylitis. The limitation of the method is that establishment of the disease in the X-ray film will take some 5-10 years after the onset of the disease.
• Computed Tomography (CT) may be advised by the doctor on a case to case basis
• Magnetic Resonance Imaging (MRI) is also a useful imaging modality and may be suggestive in some cases
• Some patient may show increase in blood levels of CRP (C Reactive Protein) and an increase in Erythrocyte Sedimentation rate (ESR). Presence of HLA-B27 in the blood can raise the suspicion
• During clinical examination Schober’s test can be performed by the doctor depending on a case to case basis

Treatment and Medicines

• Pain relieving medications i.e. NSAID’S like Aspirin, Ibuprofen, Naproxen and Ibuprofen are the first step of therapy to treat pain, inflammation and stiffness of joints. Their side effects include gastric disorders
• Opioids can also be used to relieve severe longstanding pain
• DMARD’S (Disease Modifying anti Rheumatic drugs) like corticosteroids, sulfasalazine and cyclosporine etc. can be used to treat some advanced cases
• TNF (Tumor Necrosis factor) Blockers like etanercept, infliximab etc., are a good option. These drugs are known as biologics and have shown to decrease the pace of the disease. The only limitation with this disease is that they increase the risk of infections as they suppress the immune system of the body
• Surgery can be prescribed in few cases but is a more risky procedure

• Physiotherapy combined with swimming, stretching, yoga etc. are used in conjunction with medical treatment