Published on Aug 24, 2016 and last reviewed on Sep 07, 2018 - 3 min read
This article discusses about the causes, pathology, clinical features, musculoskeletal manifestation, investigation and management of ankylosing spondylitis.
Ankylosing spondylitis is a chronic inflammatory autoimmune disorder of the spine characterized by pain and stiffness with a variable course. It mainly affects the joints of the spine and sacroiliac joint in the pelvis. As the severity increases, the joints start to fuse with each other resulting in a rigid spine.
It is thought to be genetic. The disease is more common with HLA-B27 in their first relatives such as father or mother. HLA-B27 is also present in individuals without ankylosing spondylitis development. Therefore, it is thought that there must be some other associated triggering factor responsible for the disease.
It is often associated with genitourinary or with gastrointestinal infection.
Antigen-antibody reaction triggers the inflammatory process. Inflammation is present at bone-ligament and bone-tendon junctions. There also occurs synovitis of synovial joints of the body, such as sacroiliac joint, hip joint, facet joint, etc. Joint becomes swollen and the movements of joints are limited. Destruction of articular cartilage occurs over time, followed by the subchondral bone formation.
The costovertebral joints are frequently involved with limitation of chest expansion. Inflammation of bone-ligament junctions affect the sacroiliac ligaments, intervertebral joints, symphysis pubis and manubrium sterni. The inflammatory reaction is characterized by cellular infiltration, granulation tissue formation and erosion of the adjacent bones. Granulation tissue is replaced by fibrous tissue, which gets ossified over time leading to ankylosis of the joint.
Ossification of the longitudinal ligament results in syndesmophytes. Syndesmophytes between two adjacent vertebral body bridges limit the movement and as a result the spine becomes stiff like bamboo. And so we call it as bamboo spine.
Extra Musculoskeletal Manifestations:
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To know more about ankylosing spondylitis, consult an ankylosing spondylitis specialist online -->https://www.icliniq.com/ask-a-doctor-online/pain-medicine-physician/ankylosing-spondylitis
Query: Hello doctor, I am 26 years, I had a hip resurfacing surgery eight years back. I am an HLA B27 positive, even my father is also positive. I have joint pain since last fourteen years. Now, I wish to know that, if I marry and have children will this pass on to them? What measures should I take to ens... Read Full »
Answer: Hello, Welcome to icliniq.com. About 80 % of people with ankylosing spondylitis have HLA B27 positive and only 1 to 4 % people with positive HLA B27 develop ankylosing spondylitis. That means out of 100 people with positive HLA B27 only one to four can develop ankylosing spondylitis and 96 to 99 a... Read Full »
Query: Hello doctor, I am a 43 year old female, and I have had itchy, red, and burning rashes. It all started as a few bumps on my right arm, above my eyebrow, right upper nose area, all over the jaw and chin area, right chest and upper back react badly to the sun, and it is getting worse. I have had a l... Read Full »
Answer: Hello, Welcome to icliniq.com. The rashes that you are describing along with the biopsy findings can go in favor of a connective tissue disease. Although, I would like to see the reports in detail, but as you mentioned interface dermatitis, it goes more in favor of lupus over dermatomyositis. But, ... Read Full »
Query: Hi doctor, My daughter has Erbs palsy but we did physiotherapy for three months and the doctor said she is fine but she is still struggling with the hand and this is about six months after the doctor discharged us. Please tell me what should I do. Read Full »
Answer: Hello, Welcome to icliniq.com. Thank you for providing the brief history of your daughter. I am sorry firstly to hear that your daughter is being diagnosed with Erb's palsy. Well, I would suggest you to continue physiotherapy for atleast three days a week as it will be of good help for her. Usuall... Read Full »
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