Related articles: Ankylosing spondylitis
Definition
Ankylosing spondylitis is a chronic inflammatory disease of the spine. In some cases, it can also affect the peripheral joints and tendons that hold them together.
Ankylosing spondylitis mainly affects men and usually begins between 17 and 30 years of age. The causes of the disease are still unclear, however several factors seem to contribute. The pathophysiology of ankylosing spondylitis probably involves immune-mediated inflammation; furthermore, at the base there seems to be a genetic predisposition linked to the presence of the HLA-B27 or HLA-B7 protein. The existence of a 1st degree relative with ankylosing spondylitis increases the risk of getting sick.
Most common symptoms and signs *
- Anorexia
- Aortite
- Arrhythmia
- Asthenia
- dactylitis
- Dyspnoea
- Abdominal pain
- Knee pain
- Foot pain
- Hip pain
- Hand and wrist pain
- Back pain
- Articolar pains
- Temperature
- Bone fractures
- Insomnia
- hyperkyphosis
- Backache
- Eyes reddened
- Dry skin
- Weight loss
- plaques
- pneumothorax
- Rheumatism
- Joint stiffness
- Stiffness in the muscles of the back and neck
- Sciatica
- Muscle spasms
- Scales on the skin
- Spinal stenosis
- Cough
- Bone swelling
- Articular Pouring
- Blurred vision
Further indications
Ankylosing spondylitis is characterized by a persistent and lasting spinal pain (for at least 6 months). The pain mainly affects the lower part of the column and may also involve the buttock or peripheral joints. This symptom tends to disappear with movement and exercise.
Pains in the spine can disturb sleep (nocturnal back pain), while in the morning the patient has articular rigidity which tends to improve with the passing of hours and is relieved by activity. As the disease progresses, the difficulties of movement upon awakening are accentuated and last a long time; finally, lumbago becomes recurrent.
Other symptoms that may occur in case of ankylosing spondylitis include modest fever, fatigue, anorexia, weight loss and reduced expansion of the rib cage.
Ankylosing spondylitis has a negative evolution: the vertebrae, over the years, tend to merge with each other, causing an unnatural curvature of the back. An accentuated kyphosis, in fact, is frequent in untreated patients: a fixed posture or inclined forward alleviates the lumbar pain and the spasm of the paravertebral musculature.
In addition to reducing spine movements, severe arthropathy of the hip may develop. Sometimes, peripheral joint involvement can cause yarrow tendinitis and deformity at the level of the fingers (dactylitis). Occasionally, neurological signs may occur due to sciatica, compression radiculitis and vertebral fracture.
Ankylosing spondylitis is frequently associated with other autoimmune diseases, such as psoriasis, uveitis, chronic inflammatory bowel disease, angina and cardiac conduction abnormalities. These systemic manifestations appear in about one third of patients.
The typical alterations of ankylosing spondylitis can be highlighted with the diagnostic imaging of the lumbo-sacral rachis (standard RX, CT and MRI).
Various treatments help reduce pain, maintain mobility and contain joint damage. Anti-inflammatories (NSAIDs) offer relief, alleviating pain and muscle spasm. If these drugs are not effective, TNF-a antagonists (eg etanercept, infliximab and adalimumab) may be useful, which limit the effects of the disease. To reduce peripheral joint symptoms, however, the doctor may prescribe antirheumatic drugs.
The treatment also includes regular sports activities that do not overload the joints (eg swimming) and support measures to maintain correct posture and joint mobility.
