| Ankylosing spondylitis | |
|---|---|
| Other names | Bechterew syndrome,[1] Bekhterev's disease, Bechterew's disease, morbus Bechterew, Bekhterev–Strümpell–Marie disease, Marie's disease, Marie–Strümpell arthritis, Pierre–Marie's disease[2] |
_anagoria.JPG) | |
| A 6th-century skeleton showing fused vertebrae, a sign of severe ankylosing spondylitis | |
| Specialty | Rheumatology |
| Symptoms | Back pain, joint stiffness[3] |
| Usual onset | Young adulthood[3] |
| Duration | Long term[3] |
| Causes | Unknown[3] |
| Diagnostic method | Symptom based, medical imaging, blood tests[3] |
| Treatment | Medication, exercise, and surgery[3] |
| Medication | NSAIDs, steroids, DMARDs,[3] |
| Frequency | 0.1 to 1.8%[4] |
Ankylosing spondylitis (AS) is a type of arthritis in which there is a long-term inflammation of the joints of the spine.[3] Typically the joints where the spine joins the pelvis are also affected.[3] Occasionally other joints such as the shoulders or hips are involved.[3] Eye and bowel problems may also occur.[3] Back pain is a characteristic symptom of AS, and it often comes and goes.[3] Stiffness of the affected joints generally worsens over time.[3][5]
Although the cause of ankylosing spondylitis is unknown, it is believed to involve a combination of genetic and environmental factors.[3] More than 90% of those affected in the UK have a specific human leukocyte antigen known as the HLA-B27 antigen.[6] The underlying mechanism is believed to be autoimmune or autoinflammatory.[7] Diagnosis is typically based on the symptoms with support from medical imaging and blood tests.[3] AS is a type of seronegative spondyloarthropathy, meaning that tests show no presence of rheumatoid factor (RF) antibodies.[3] It is also within a broader category known as axial spondyloarthritis.[8]
There is no cure for ankylosing spondylitis.[3] Treatments may improve symptoms and prevent worsening.[3] This may include medication, exercise, and surgery.[3] Medications used include NSAIDs, steroids, DMARDs such as sulfasalazine, and biologic agents such as TNF inhibitors.[3]
Between 0.1% and 1.8% of people are affected.[4] Onset is typically in young adults.[3] Males are more often affected than females.[3] The condition was first fully described in the late 1600s by Bernard Connor, but skeletons with ankylosing spondylitis are found in Egyptian mummies.[9] The word is from Greek ankylos meaning to unite or grow together, spondylos meaning vertebra, and -itis meaning inflammation.[3]
References
edit- ^ "Orphanet: NON RARE IN EUROPE: Ankylosing spondylitis". www.orpha.net. Archived from the original on 31 May 2024. Retrieved 18 June 2024.
- ^ Matteson EL, Woywodt A (November 2006). "Eponymophilia in rheumatology". Rheumatology. 45 (11): 1328–30. doi:10.1093/rheumatology/kel259. PMID 16920748. Archived from the original on 14 March 2020. Retrieved 19 July 2020.
- ^ a b c d e f g h i j k l m n o p q r s t u v w "Questions and Answers about Ankylosing Spondylitis". NIAMS. June 2016. Archived from the original on 28 September 2016. Retrieved 28 September 2016.
- ^ a b Khan, Muhammad Asim (2009). Ankylosing Spondylitis. Oxford University Press. p. 15. ISBN 9780195368079. Archived from the original on 8 September 2017.
- ^ "Ankylosing spondylitis". GARD. 9 February 2015. Archived from the original on 2 October 2016. Retrieved 28 September 2016.
- ^ Sheehan NJ (January 2004). "The ramifications of HLA-B27". Journal of the Royal Society of Medicine. 97 (1): 10–4. doi:10.1258/jrsm.97.1.10. PMC 1079257. PMID 14702356.
- ^ 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.
- ^ Deodhar A, Reveille JD, van den Bosch F, Braun J, Burgos-Vargas R, Caplan L, et al. (October 2014). "The concept of axial spondyloarthritis: joint statement of the spondyloarthritis research and treatment network and the Assessment of SpondyloArthritis international Society in response to the US Food and Drug Administration's comments and concerns". Arthritis & Rheumatology. 66 (10): 2649–56. doi:10.1002/art.38776. PMID 25154344.
- ^ Boos, Norbert; Aebi, Max (2008). Spinal Disorders: Fundamentals of Diagnosis and Treatment. Springer Science & Business Media. p. 25. ISBN 9783540690917. Archived from the original on 8 September 2017.