Ankylosing Spondylitis (Axial Spondyloarthritis)

Ankylosing Spondylitis (Axial Spondyloarthritis)

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What is Ankylosing Spondylitis (Axial Spondyloarthritis)?

Ankylosing Spondylitis (AS), a type of axial spondyloarthritis, is a chronic inflammatory disease primarily affecting the spine and sacroiliac joints. Characterized by pain, stiffness, and eventual fusion of the spine, AS can lead to significant functional impairments. Early diagnosis and appropriate treatment are crucial for managing symptoms and maintaining mobility.

Ankylosing Spondylitis (Axial Spondyloarthritis) Statistics

"

  • Ankylosing Spondylitis affects approximately 0.1% to 1.4% of the population worldwide.
  • The male-to-female ratio for AS is approximately 2:1 for radiographic forms and 1:1 for non-radiographic forms.
  • The highest prevalence rates are observed in Europe (23.8 per 10,000) and Asia (16.7 per 10,000).
  • Source: Rheumatology Journal
    • "

    Ankylosing Spondylitis (Axial Spondyloarthritis) Anatomy

  • Sacroiliac joints: The primary site of inflammation, where the spine meets the pelvis.
  • Vertebral column: Involves 24 vertebrae, which may fuse together due to inflammation and ossification.
  • Entheses: Sites where ligaments and tendons attach to bones, often inflamed in AS.
  • Syndesmophytes: Bony growths that form between vertebrae, leading to spine fusion.

    • Ankylosing Spondylitis (Axial Spondyloarthritis)
    Signs & Symptoms

  • Chronic back pain and stiffness, particularly in the lower back and buttocks.
  • Pain and stiffness worsen with inactivity and improve with exercise.
  • Morning stiffness lasting more than 30 minutes.
  • Limited range of motion in the spine.
  • Possible involvement of peripheral joints, especially hips, knees, and shoulders.

    • Causes of Ankylosing Spondylitis (Axial Spondyloarthritis)

  • Genetic predisposition, particularly the presence of the HLA-B27 gene.
  • Environmental factors, such as microbial infections, may trigger the onset of AS.
  • Immune system dysregulation plays a role in the inflammation process.

    • Risk Factors for Ankylosing Spondylitis (Axial Spondyloarthritis)

  • Positive HLA-B27 status, present in 90-95% of AS patients.
  • Family history of ankylosing spondylitis or related conditions.
  • Onset typically occurs between ages 20-40.
  • More common in males than females for radiographic AS.

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    Prevalence of Ankylosing Spondylitis (Axial Spondyloarthritis)

  • AS prevalence is higher in European and Asian populations, with lower rates in Latin America.
  • Global prevalence ranges from 0.1% to 1.4%.
  • Symptoms typically begin between the ages of 20-40.

    • Assessment & Diagnosis of Ankylosing Spondylitis (Axial Spondyloarthritis)

  • Physical examination: Focus on sacroiliac joints, spinal mobility, and chest expansion.
  • X-rays: Used to identify characteristic changes such as vertebral squaring and syndesmophytes.
  • MRI: More sensitive than X-rays in detecting early sacroiliitis.
  • Laboratory tests: HLA-B27 test, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) are common.

    • Rehabilitation & Physiotherapy for Ankylosing Spondylitis (Axial Spondyloarthritis)

  • Phase 1: Focus on pain management, maintaining joint mobility, and preventing deformities.
  • Phase 2: Implement exercises to improve spinal mobility, strength, and posture correction.
  • Phase 3: Long-term management including regular physical activity, flexibility exercises, and patient education.
  • Considerations: Fatigue management, joint protection strategies, and adherence to exercise programs.

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    Ankylosing Spondylitis (Axial Spondyloarthritis) FAQs

    Early symptoms of ankylosing spondylitis include chronic lower back pain, stiffness that improves with exercise but not rest, and morning stiffness lasting more than 30 minutes.

    Ankylosing spondylitis is diagnosed through a combination of physical exams, imaging studies (X-ray, MRI), and lab tests such as the HLA-B27 gene test and inflammatory markers like CRP and ESR.

    Yes, physiotherapy is crucial in managing ankylosing spondylitis. It helps maintain spinal mobility, reduce pain, improve posture, and enhance overall quality of life.

    Ankylosing Spondylitis (Axial Spondyloarthritis) References

  • Rheumatology Journal - Global Prevalence of Ankylosing Spondylitis
  • NCBI - Ankylosing Spondylitis Overview

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