Ankylosing Spondylitis | Course of Disease | Rheumatology

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sqadia.com brings you this Medicine Rheumatology lecture on Ankylosing Spondylitis, which is part of the group of inflammatory diseases called spondyloarthritis.

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Lecture Duration - 01:35:25
Release Date - July 2020

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Ankylosing spondylitis (AS) is a rare type of arthritis that primarily affects the axial skeleton, peripheral joints & extraarticular structures. The inflammation causing the fusion of bones around joints, most commonly the neck, lumbosacral and sacroiliac joints

Dr. Ali Imran lets us know that ankylosing spondylitis is a lifelong condition, also known as Bechterew disease, prevalent more in males but quite underdiagnosed in females.

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✔️ ️Pathology of Ankylosing Spondylitis
However, the underlying cause of ankylosing spondylitis is still unknown, the pathology of the inflammation of joints is quite elucidated. Usually starts in lower back and may spread up to neck and other parts of body.

The eroded joint results in inflammation, formation of syndesmophyte, and eventually fusion of the joint.

✔️ Ankylosing Spondylitis Pathogenesis
The pathogenesis of ankylosing spondylitis is explained. Along with precipitating factors, which may include misfolding of certain proteins like interleukins (IL), human leukocyte antigens (HLA) and tumor necrosis factor (TNFα).

AS patients display a characteristic lesion due to enthesitis, sacroiliitis and, synovitis.

✔️ Ankylosing Spondylitis Clinical Manifestations
Upon physical examinations, Schober test, and chest expansion test, ankylosing spondylitis patients display chronic pain and “bamboo spine” appearance, along with eye (uveitis), gastrointestinal tract (irritable bowel diseases or IBD) and skin (psoriasis) symptoms.

✔️ Ankylosing Spondylitis Course of Disease
The course of progression of AS from mild stiffness to fused spine and arthritis, depends upon different factors. The level of pain, and differing symptoms exhibition in women, must be kept in mind.

✔️ Ankylosing Spondylitis Diagnosis
Assessment of SpondyloArthritis international Society (ASAS) has annotated the diagnostic criteria for ankylosing spondylitis based on symptoms, for rheumatologists.

Physical examination of symptoms, laboratory tests to look for signs of inflammation (blood and synovial fluids), along with bone imaging techniques- X-ray, MRI, CT scan, Dual-energy X-ray absorptiometry (DEXA scan), all may be employed to get a final diagnosis of ankylosing spondylitis.

✔️️ Ankylosing Spondylitis Treatment
Pharmaceutical treatment like anti-inflammatory drugs and lifestyle changes have shown promising results in the treatment. Surgery is rarely done to manage symptoms in patients.

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