Ankylosing spondylitis

Ankylosing spondylitis
Other namesBekhterev's disease, Bechterew's disease, morbus Bechterew, Bekhterev–Strümpell–Marie disease, Marie's disease, Marie–Strümpell arthritis, Pierre–Marie's disease[1]
A 6th-century skeleton showing fused vertebrae, a sign of severe ankylosing spondylitis
SpecialtyRheumatology
SymptomsBack pain, joint stiffness[2]
ComplicationsEye inflammation (uveitis), Compression fractures, Heart problems.[3]
Usual onsetYoung adulthood[2]
DurationLifetime[2]
CausesUnknown[2]
Diagnostic methodSymptoms, medical imaging and blood tests[2]
TreatmentMedication, physical therapy
MedicationNSAIDs, steroids, DMARDs,[2] TNF Inhibitor
Frequency0.1 to 0.8%[4]

Ankylosing spondylitis (AS) is a type of arthritis from the disease spectrum of axial spondyloarthritis.[5] It is characterized by long-term inflammation of the joints of the spine, typically where the spine joins the pelvis.[2] With AS, eye and bowel problems—as well as back pain—may occur.[2] Joint mobility in the affected areas sometimes worsens over time.[2][6] Ankylosing spondylitis is believed to involve a combination of genetic and environmental factors.[2] More than 90% of people affected in the UK have a specific human leukocyte antigen known as the HLA-B27 antigen.[7] The underlying mechanism is believed to be autoimmune or autoinflammatory.[8] Diagnosis is based on symptoms with support from medical imaging and blood tests.[2] AS is a type of seronegative spondyloarthropathy, meaning that tests show no presence of rheumatoid factor (RF) antibodies.[2]

There is no cure for AS. Treatments may include medication, physical therapy, and surgery. Medication therapy focuses on relieving the pain and other symptoms of AS, as well as stopping disease progression by counteracting long-term inflammatory processes. Commonly used medications include NSAIDs, TNF inhibitors, IL-17 antagonists, and DMARDs. Glucocorticoid injections are often used for acute and localized flare-ups.[9]

About 0.1% to 0.8% of the population are affected, with onset typically occurring in young adults.[2][4] While men and women are equally affected with AS, women are more likely to experience inflammation rather than fusion.[10]

  1. ^ Matteson EL, Woywodt A (November 2006). "Eponymophilia in rheumatology". Rheumatology. 45 (11): 1328–30. doi:10.1093/rheumatology/kel259. PMID 16920748.
  2. ^ a b c d e f g h i j k l m "Questions and Answers about Ankylosing Spondylitis". NIAMS. June 2016. Archived from the original on 28 September 2016. Retrieved 28 September 2016.
  3. ^ "Ankylosing spondylitis". mayoclinic.org. Mayo Clinic. Retrieved 5 June 2022.
  4. ^ a b Khan MA (2009). Ankylosing Spondylitis. Oxford University Press. p. 15. ISBN 9780195368079. Archived from the original on 8 September 2017.
  5. ^ Ivanova, Mariana; Zimba, Olena; Dimitrov, Ivan; Angelov, Alexander K.; Georgiev, Tsvetoslav (1 September 2024). "Axial Spondyloarthritis: an overview of the disease". Rheumatology International. 44 (9): 1607–1619. doi:10.1007/s00296-024-05601-9. ISSN 1437-160X.
  6. ^ "Ankylosing spondylitis". GARD. 9 February 2015. Archived from the original on 2 October 2016. Retrieved 28 September 2016.
  7. ^ Sheehan NJ (January 2004). "The ramifications of HLA-B27". Journal of the Royal Society of Medicine. 97 (1): 10–4. doi:10.1177/014107680409700102. PMC 1079257. PMID 14702356.
  8. ^ Smith JA (January 2015). "Update on ankylosing spondylitis: current concepts in pathogenesis". Current Allergy and Asthma Reports. 15 (1): 489. doi:10.1007/s11882-014-0489-6. PMID 25447326. S2CID 24623808.
  9. ^ Cite error: The named reference :0 was invoked but never defined (see the help page).
  10. ^ "Facts and Figures". National Axial Spondyloarthritis Society. Retrieved 27 January 2021.