Ankylosing spondylitis

Ankylosing Spondylitis 

Definition

Ankylosing spondylitis (AS) refers to inflammation of the joints in the spine. AS is also known as rheumatoid spondylitis or Marie-Strümpell disease (among other names).

Description

A form of arthritis, AS is characterized by chronic inflammation, causing pain and stiffness of the back, progressing to the chest and neck. Eventually, the whole back may become curved and inflexible if the bones fuse (this is known as "bamboo spine"). AS is a systemic disorder that may involve multiple organs, such as the:

Less than 1% of the population has AS; however, 20% of AS sufferers have a relative with the disorder.

Causes and symptoms

Genetics play an important role in the disease, but the cause of AS is still unknown. More than 90% of patients have a gene called HLA-B27, but only 10-15% of those who inherit the gene develop the disease. Symptoms of AS include:

AS is seen most commonly in males 30 years old and older. Initial symptoms are uncommon after the age of 30, although the diagnosis may not be established until after that age. The incidence of AS in Afro-Americans is about 25% of the incidence in Caucasians.

Diagnosis

Doctors usually diagnose the disease simply by the patient's report of pain and stiffness. Doctors also review spinal and pelvic x rays since involvement of the hip and pelvic joints is common and may be the first abnormality seen on the x ray. The doctor may also order a blood test to determine the presence of HLA-B27 antigen. When a diagnosis is made, patients may be referred to a rheumatologist, a doctor who specializes in treating arthritis. Patients may also be referred to an orthopedic surgeon, a doctor who can surgically correct joint or bone disorders.

Treatment

Physical therapists prescribe exercises to prevent a stooped posture and breathing problems when the spine starts to fuse and ribs are affected. Back braces may be used to prevent continued deformity of the spine and ribs. Only in severe cases of deformity is surgery performed to straighten and realign the spine, or to replace knee, shoulder, or hip joints.

Alternative treatment

To reduce inflammation various herbal remedies, including white willow (Salix alba), yarrow (Achillea millefolium), and lobelia (Lobelia inflata), may be helpful. Acupuncture, performed by a trained professional, has helped some patients manage their pain. Homeopathic practitioners may prescribe such remedies as Bryonia and Rhus toxicodendron for pain relief.

Prognosis

There is no cure for AS, and the course of the disease is unpredictable. Generally, AS progresses for about 10 years and then its progression levels off. Most patients can lead normal lives with treatment to control symptoms.

Prevention

There is no known way to prevent AS.

Key terms

Ankylosing — When bones of a joint are fused, stiff, or rigid.

HLA-B27 — An antigen or protein marker on cells that may indicate ankylosing spondylitis.

Immune suppressing — Anything that reduces the activity of the immune system.

Inflammation — A reaction of tissues to disease or injury, often associated with pain and swelling.

Spondylitis — An inflammation of the spine.

Resources

Organizations

Arthritis Foundation.1300 W. Peachtree St., Atlanta, GA 30309. (800) 283-7800. http://www.arthritis.org.

National Institute of Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse. 1 AMS Circle, Bethesda, MD 29892-3675. (301) 495-4484.

Spondylitis Association of America. P.O. Box 5872, Sherman Oaks, CA 91413. (800) 777-8189.

Other

Matsen III, Frederick, ed. "Ankylosing Spondylitis." University of Washington Orthopaedics and Sports Medicine. http://www.orthop.washington.edu/arthritis/types/ankylosingspondylitis.

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ankylosing spondylitis

n.

Arthritis of the spine, resembling rheumatoid arthritis and leading to lipping or fusion of the vertebrae. Also called Strümpell-Marie disease, Marie-Strümpell disease, rheumatoid spondylitis, Strümpell-Marie disease.

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ankylosing spondylitis (ang·ki·lōˑ·sing spän·d·līˑ·ts),

n a painful, progressive, arthritic condition in which some (or, rarely, all) of the spinal joints and vertebrae fuse together. It may also affect other joints and ligaments. Administration of antiinflammatory drugs and regular exercise help control inflammation and reduce pain. Also called
AS.