Ankylosing Spondylitis

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Clinic

  • AS is a type of arthritis characterized by long-term inflammation of the joints of the spine typically where the spine joins the pelvis.
  • AS is a systemic rheumatic disease, meaning it affects the entire body.
  • Occasionally areas affected may include other joints such as the shoulders or hips, eye and bowel problems may occur as well as back pain.
  • Joint mobility in the affected areas generally worsens over time.
  • Causation is unknown
  • There is no known cure for it


Signs and symptoms

  • Signs and symptoms often appear gradually, with peak onset between 20 -30 years of age.
  • Initial symptoms are usually a chronic dull pain in the lower back or gluteal region combined with stiffness of the lower back.
  • Pain and stiffness awakens them in the early morning hours.
  • As the disease progresses, loss of spinal mobility and chest expansion, with a limitation of anterior flexion, lateral flexion, and extension of the lumbar spine are seen.
  • Systemic features are common with weight loss, fever, or fatigue often present.
  • Pain is often severe at rest but may improve with physical activity.
  • Inflammation and pain may recur to varying degrees regardless of rest and movement.
  • AS can occur in any part of the spine or the entire spine, often with pain localized to either buttock or the back of the thigh from the sacroiliac joint.
  • Arthritis in the hips and shoulders may also occur.
  • When the condition presents before the age of 18, AS is more likely to cause pain and swelling of large lower limb joints, such as the knees.
  • In prepubescent cases, pain and swelling may also manifest in the ankles and feet where heel pain and enthesopathy commonly develop. Less common occurrences include ectasia of the sacral nerve root sheaths.


Extra Sign/ Symptoms

  • About 30% of people with AS will also experience anterior uveitis causing eye pain, redness, and blurred vision.
  • Cardiovascular involvement may include inflammation of the aorta, aortic valve insufficiency or disturbances of the heart's electrical conduction system.
  • Lung fibrosis

Miasms

MTB