ANKYLOSING SPONDYLITIS
This form of arthritis causes the joints in the spine to become stiff and swollen. In some instances, stiff joints can fuse (grow together). The most common symptoms are pain and stiffness in the buttocks and lower back (particularly in the morning) that continue for over three months. Ankylosing spondylitis is most common in men and often begins between 20 and 40.
So it is clear that ankylosing spondylitis primarily affects the spine or back. The joints and ligaments that typically permit the spine to move become inflamed and stiff. The spine’s bones may grow together, causing the spine to become rigid and inflexible. Other joints, such as the hips, shoulders, knees, or ankles, also may become involved. Heredity seems to play a role in determining who gets ankylosing spondylitis, as it is noticed that approximately one in five people affected by ankylosing spondylitis have a relative with the same disorder. A gene called HLA-B27 is present in over 90 per cent of people with ankylosing spondylitis. 10-15 per cent of individuals who inherit the gene will demonstrate ankylosing spondylitis.
Almost everyone with ankylosing spondylitis can expect to lead every day and productive lives. Despite the chronic nature of the illness, only a few people with ankylosing spondylitis will become severely disabled. Managing pain and controlling inflammation can reduce the daily problems that may occur with ankylosing spondylitis. By watching posture and Almost always involved body position and doing exercises daily, the individual can control many of the effects of the disease. Symptoms of ankylosing spondylitis appear most frequently in young men between 16 and 35. It is less common in women, whose symptoms are often milder and more challenging to diagnose. About five per cent of ankylosing spondylitis begins in childhood; boys are more likely to have it than girls.
When children develop ankylosing spondylitis, it usually begins in the hips, knees and bottoms of heels or big toes and may later progress to involve the spine. The inflammation in ankylosing spondylitis usually starts with back pain. Typically, symptoms lessen with movement and exercise. Over time, pain and stiffness may progress into the upper spine, chest, and neck. Ultimately, the inflammation can cause the sacroiliac and vertebral bones of the whole spine to become rigid.
Similarly, the bones in the chest may fuse, causing a loss of normal chest expansion when breathing. The hips, shoulders, knees, or ankles may also become inflamed and painful and eventually lose mobility. The heels may become affected, making standing or walking on hard surfaces uncomfortable. Ankylosing spondylitis is a systemic disease that affects the entire body in some people. It can cause fever, loss of appetite and fatigue, and damage other organs besides the joints, such as the lungs, heart and eyes.
The eye is the most common organ affected by ankylosing spondylitis. Eye inflammation (iritis) occurs occasionally in one-fourth of people with ankylosing spondylitis. Iritis results in a red, painful eye that worsens by looking at bright light. It is a severe condition requiring immediate medical attention by an ophthalmologist. Less frequently, ankylosing spondylitis may be associated with a scaly skin condition called psoriasis. In rare cases, ankylosing spondylitis may cause problems with the heart, lungs, or intestines. Symptoms similar to that seen in ankylosing spondylitis also may occur along with such conditions as psoriasis, inflammatory bowel disease, or Reiter’s syndrome. Doctors usually base their diagnosis of ankylosing spondylitis on symptoms (pain, stiffness) and X-rays showing involvement of the sacroiliac joint at the back of the pelvis. If the symptoms and X-rays suggest ankylosing spondylitis, but the diagnosis is uncertain, the doctor may perform a blood test to check you for the HLA – B27 gene. About 90 per cent of people diagnosed with ankylosing spondylitis test positive for this gene. Treatment for ankylosing spondylitis should be designed to reduce pain and stiffness, prevent deformities and maintain everyday activities.