Ankylosing Spondylitis

Ankylosing spondylitis is a type of arthritis of the spine. It causes swelling between your vertebrae, which are the disks that make up your spine, and in the joints between your spine and pelvis. Ankylosing spondylitis is an autoimmune disease. This means your immune system, which normally protects your body from infection, attacks your body's own tissues. The disease is more common and more severe in men. It often runs in families.

Early symptoms include back pain and stiffness. These problems often start in late adolescence or early adulthood. Over time, ankylosing spondylitis can fuse your vertebrae together, limiting movement. Symptoms can worsen or improve or stop altogether. The disease has no cure, but medicines can relieve the pain, swelling and other symptoms. Exercise can also help.

National Institute of Arthritis and Musculoskeletal and Skin Disease

Ankylosing Spondylitis on Wikipedia

'''Ankylosing spondylitis (AS)''' is a chronic, progressive inflammatory arthritis primarily affecting vertebral column and sacroiliac joints, causing eventual fusion of the spine; it is a member of the group of the spondyloarthropathy. Complete fusion results in a complete rigidity of the spine, a condition known as '''bamboo spine'''. Treatment is with physiotherapy and medication. Some cases remain mild, while other result in marked disability.

Signs and symptoms

The typical patient is a young man of 15-30 years old (although women are also affected) with pain and stiffness in the spine. It is also associated with iridocyclitis (anterior uveitis), ulcerative colitis, psoriasis and Reiter's disease, through HLA-B27 (see below). Organs affected by AS, other than the axial vertebral column, are the hips, heart, heels, and other areas (peripheral).

Diagnosis

The diagnosis is by X-ray studies of the spine, which show characteristic spinal changes and sacroiliitis. A normal X-ray does not exclude the disease. HLA-B27 (demonstrated in a blood test) is occasionally used, but does not distinguish AS from other diseases and is therefore not of real diagnostic value.

Pathophysiology

AS is a systemic rheumatic disease, and about 90% of the patients are HLA-B27 positive. HLA-DR and IL1ra are also implicated in ankylosing spondylitis. Although specific autoantibodies cannot be detected, its response to immunosuppresive medication has prompted its classification as an autoimmune disease. Hypotheses on its pathogenesis include a cross-reaction with antigens of the ''Klebsiella'' bacterial strain (Tiwana ''et al.'' 2001). Particular authorities argue that elimination of the prime nutrients of ''Klebsiella'' (starches) would decrease antigenemia and improve the musculoskeletal symptoms. On the other hand, Khan (2002) argues that the evidence ... [ Read More ]

External Resources

National Ankylosing Spondylitis Society - UK - Information and support online along with addresses for other societies worldwide.

Washington University - Description of ankylosing spondylitis, and ideas for reducing symptoms.

Ankylosing Spondylitis International Federation - World-wide roof organization, lists addresses and additional data of self-help societies of patients suffering from AS or related diseases in 30 countries.

About.com: Ankylosing Spondylitis - Links to news, information, and support.

Health Factsheet from BUPA - Explains the causes, symptoms and treatment of Ankylosing spondylitis.

My Back Pages Regarding Ankylosing Spondylitis - Personal pages of Chris Gates telling of his experience with the condition.

Ankylosing Spondylitis - Cause and Treatment - An unconventional look at the condition by Gabe Mirkin, M.D., with journal references.

National Ankylosing Spondylitis Society - Information on physiotherapy, hydrotherapy, advice and support for sufferers in the Surrey (UK) area around Woking, Weybridge, Egham, Guildford and Camberley. Other useful AS links and information included.

An AS Story - The personal experiences of living with Ankylosing Spondylitis, what it is and the reality of living with it.

Ankylosing Spondylitis and Undifferentiated Spondyloarthropathy - Full text article from eMedicine.

Ankylosing Spondylitis