Ankylosing spondylitis (pronounced ankle-oh-sing spon-dill-eye-tiss) is a form of arthritis that causes chronic (long-term) spine inflammation. Ankylosing spondylitis (AS) inflames the sacroiliac joints located between the base of the spine and pelvis. This inflammation, called sacroiliitis, is one of the first signs of AS. Inflammation often spreads to joints between the vertebrae, the bones that make up the spinal column. This condition is known as spondylitis.

Some people with AS experience severe, persistent back and hip pain and stiffness. Others have milder symptoms that come and go. Over time, new bone formations may fuse vertebrae sections together, making the spine rigid. This condition is called ankylosis.

How common is ankylosing spondylitis (AS)?

Ankylosing spondylitis belongs to a group of diseases known as spondyloarthropathies. some three and 13 out of 1,000 Americans have one of these diseases.

Who might have ankylosing spondylitis (AS)?

Anyone can get AS, although it affects more men than women. Symptoms usually appear in people between the ages of 17 and 45. Ankylosing spondylitis has a genetic link and may run in families.

SYMPTOMS AND CAUSES

What causes ankylosing spondylitis (AS)?

About 95% of people who have AS have a variation of the human leukocyte antigen-B gene (HLA-B). This changed, or mutated, gene produces a protein called HLA-B27 that increases disease risk. However, most people with a mutated HLA-B gene don’t get AS. In fact, 80% of children who inherit the mutated gene from a parent with AS don’t develop the disease. Some 60 genes have been linked to the condition.

Having one of these conditions may also increase your risk:

• Crohn’s disease.
• Ulcerative colitis.
• Psoriasis.

What are the symptoms of ankylosing spondylitis (AS)?

Symptoms typically appear between the ages of 17 and 45 but may develop in younger children or older adults. Some people have persistent pain, while others experience milder symptoms. Symptoms may flare up (worsen) and improve (go into remission) off and on. If you have ankylosing spondylitis, you may experience:

• Lower back pain and stiffness.
• Hip pain.
• Joint pain.
• Neck pain.
• Difficulty breathing.
• Fatigue.
• Loss of appetite and unexplained weight loss.
• Abdominal pain and diarrhea .
• Skin rash.
• Vision problems.

DIAGNOSIS AND TESTS

How is ankylosing spondylitis (AS) diagnosed?

There isn’t a test that definitively diagnoses ankylosing spondylitis. After reviewing your symptoms and family history, your healthcare provider will perform a physical exam. Your provider may order one or more of these tests to help guide diagnosis:

• Imaging scans: MRI( Magnetic Resonance Imaging) scans can detect spine problems earlier than traditional X-rays. Still, your provider may order spine x-rays to check for arthritis or rule out other problems.
• Blood tests: Blood tests can check for the presence of the HLA-B27 gene. About 8% of people of European descent have this gene, but only a quarter of them develop ankylosing spondylitis.

MANAGEMENT AND TREATMENT

What are the complications of ankylosing spondylitis (AS)?

Ankylosing spondylitis may affect more than the spine. The disease may inflame joints in the pelvis, shoulders, hips and knees, and between the spine and ribs. People with AS are more prone to spinal fractures (broken vertebrae). Other complications include:

• Fused vertebrae (ankylosis).
• Kyphosis (forward curvature of the spine).
• Osteoporosis.
• Painful eye inflammation (iritis or uveitis) and sensitivity to light (photophobia).
• Heart disease, including aortitis, arrhythmia and cardiomyopathy.
• Chest pain that affects breathing.
• Jaw inflammation.
• Cauda equina syndrome (nerve scarring and inflammation).

PREVENTION

How can I prevent ankylosing spondylitis (AS)?

Because ankylosing spondylitis has no known cause, there isn’t any way to prevent it.

Stages of sarcoidosis

Sarcoidosis can affect any part of the body, but it commonly impacts the lungs. Pulmonary sarcoidosis, or sarcoidosis of the lungs, can be categorized into four stages.

Staging helps doctors understand how advanced the condition is. It can also help them understand which treatments might be right for you.

A stage is assigned after a chest X-ray. This imaging test reveals several important factors about how the condition is affecting your lungs. Stage 1 to stage 4 are the crucial phases that progress from mild to advanced .

OUTLOOK / PROGNOSIS

What is the prognosis (outlook) for people who have ankylosing spondylitis (AS)?

You should call your rheumatologist if you have AS and experience:

• Chest pain.
• Difficulty breathing.
• Vision problems.
• Severe back pain or other joint pain.
• Spine rigidity.
• Unexplained weight loss.

The Takeaway :

Ankylosing spondylitis symptoms may gradually worsen as you age. The condition is rarely disabling or life-threatening. Still, symptoms like joint pain may interfere with your ability to do the things you love. Early interventions can ease inflammation and pain. A combination of physical activity and prescribed medications from your rheumatologist can help.