What is ankylosing spondylitis

There are many common diseases in life. Different diseases have different symptoms and causes. When treating diseases, it is also necessary to understand these. In this way, when treating your own diseases, you will know what method is best. So what is ankylosing spondylitis? This type of disease is also not clear to many people, and after this type of disease occurs, the human body will also have obvious manifestations.

Many people are not clear about what ankylosing spondylitis is. This type of disease causes great damage to the human skeleton. After the occurrence of this type of disease, the human joints are seriously damaged. Therefore, when treating this type of disease, it is also necessary to choose the correct method.

What is Ankylosing Spondylitis?

Ankylosing spondylitis (AS) is a disease characterized by inflammation of the sacroiliac joints and spinal attachment points. Strong association with HLA-B27. Some microorganisms (such as Klebsiella) have common antigens with the susceptible person's own tissues and can induce abnormal immune responses. It is a chronic inflammatory disease characterized by fibrosis and ossification of the large joints of the limbs, the annulus fibrosus of the intervertebral disc and its surrounding connective tissue, and ankylosis of the joints. Ankylosing spondylitis belongs to the category of rheumatic diseases and is a type of seronegative spondyloarthropathy. The cause of this disease is still unclear. It is a chronic disease with the spine as the main site of lesions, involving the sacroiliac joints, causing spinal stiffness and fibrosis, and causing varying degrees of eye, lung, muscle, and bone lesions. It is an autoimmune disease.

Clinical manifestations

1. Initial symptoms

For young people aged 16 to 25, especially young men. Ankylosing spondylitis generally has an insidious onset and may not have any clinical symptoms in the early stages. Some patients may show mild systemic symptoms in the early stages, such as fatigue, weight loss, long-term or intermittent low fever, anorexia, mild anemia, etc. As the disease is relatively mild, most patients cannot detect it early, resulting in delayed disease progression and loss of the best time for treatment.

2. Manifestations of joint disease

AS patients often have joint lesions, and most of them first invade the sacroiliac joints and then progress upward to the cervical spine. In a small number of patients, the cervical spine or several spinal segments are first affected, and the surrounding joints may also be affected. In the early stage, there is inflammatory pain in the joints at the lesion site, accompanied by muscle spasms around the joints and a feeling of stiffness, which is more obvious in the morning. It may also manifest as night pain, which is relieved by activity or taking analgesics. As the disease progresses, joint pain decreases, but the movement of each spinal segment and joint becomes restricted and deformed. In the late stage, the entire spine and lower limbs become rigid, arched, and bent forward.

(1) Sacroiliitis: About 90% of AS patients first present with sacroiliitis. Later it develops upward to the cervical spine, manifesting as recurrent low back pain, stiffness in the lumbar region, intermittent or alternating low back pain and pain in both buttocks, which may radiate to the thighs. There are no positive physical signs, and the straight leg raising test is negative. However, direct pressure or stretching of the sacroiliac joint may cause pain. Some patients have no symptoms of sacroiliitis, and only abnormal changes are found in X-ray examinations. About 3% of AS first affect the cervical spine and then spread downward to the lumbar sacral region. In 7% of AS, almost the entire spine is affected simultaneously.

(2) Lumbar spine disease When the lumbar spine is affected, most symptoms include limited movement of the lower back and waist. Lumbar flexion, extension, lateral bending and rotation may all be limited. Physical examination may reveal tenderness of the lumbar spinal processes and paralumbar muscle spasm; in the later stages, lumbar muscle atrophy may occur.

(3) Thoracic vertebrae disease When the thoracic spine is affected, symptoms include back pain, anterior chest pain, and lateral chest pain, with the most common deformity being kyphosis. If the costovertebral joints, manubrium-sternosal joints, sternoclavicular joints and intercostal cartilage joints are affected, the chest pain will be band-like, the chest expansion will be limited, and the chest pain will be aggravated when inhaling, coughing or sneezing. In severe cases, the chest cavity remains in the exhalation state, and the chest expansion is reduced by more than 50% compared with normal people, so it can only be assisted by abdominal breathing. Due to the reduction in the capacity of the chest and abdominal cavity, heart, lung and digestive functions are impaired.

(4) A small number of patients with cervical spondylosis first present with cervical spondylitis, with pain in the cervical spine that radiates along the neck to the head and arms. The neck muscles initially spasm and then atrophy, and the disease may progress to kyphosis of the cervical and thoracic spine. The movement of the head is significantly limited, and it is often fixed in a flexed position and cannot be tilted upward, bent sideways or rotated. In severe cases, the patient can only see the small piece of ground in front of his or her toes and cannot lift his or her head to look straight ahead.

(5) Peripheral joint lesions: About half of AS patients have transient acute peripheral arthritis, and about 25% have permanent peripheral joint damage. It usually occurs in large joints and more often in the lower limbs than in the upper limbs. When the shoulder joint is affected, joint movement is limited, the pain is more obvious, and activities such as combing the hair and raising the hands are restricted. When the knee joint is invaded, the joint will bend compensatorily, making daily life such as walking and sitting more difficult. It rarely affects the elbow, wrist and foot joints.

In addition, the pubic symphysis may also be affected, and the upper edge of the pelvis, ischial tuberosity, greater trochanter of the femur and heel may have symptoms of osteitis, which manifests as local soft tissue swelling and pain in the early stage and bone enlargement in the late stage. Generally, peripheral arthritis may occur before or after spondylitis. The local symptoms are difficult to distinguish from rheumatoid arthritis, but fewer people have residual deformities.

Through the above introduction, we have explained one by one what ankylosing spondylitis is. When treating this type of disease, it is also necessary to choose the correct treatment method. However, it should be noted that when treating this type of disease, it also takes some time, so patients and their families also need to actively cooperate.