09 June 2013

Arthroblog No 9 - Ankylosing Spondylitis (AS)


Christine Steinier
The “spondylitis” bit refers to spinal inflammation. Ankylosing means that the moving parts of the spine stiffen up progressively. AS is one cause of low back pain and stiffness in young men, but women can also develop the condition. The sex ratio in favour of males is 3:1.

In the late 19th century, Vladimir von Bechterew, Adolph Strumpel and Pierre Marie provided descriptions of the disease, which allowed it to be adequately diagnosed. Apart from spinal involvement, AS can affect peripheral joints and the eye.

Conditions such as psoriatic arthritis, Reiter’s disease, and inflammatory bowel disease can be associated with AS.

There is a high (90-95%) preponderance of a particular tissue type called HLA B27. About 7-8% of the general population have this tissue type but this does not necessarily mean that you will develop the disease - it is a definite risk factor. The cause of AS is not known but there is some good evidence that its onset may be linked to a bacterial trigger.

An old saying amongst doctors is that every patient with ankylosing spondylitis has a sad story to tell – a story of vague backache which has been treated for years with this, that and the other, all without benefit.

With the current emphasis on earlier and more accurate diagnosis and the availability of biological agents for treatment, the prognosis for sufferers has improved remarkably.The “spondylitis” bit refers to spinal inflammation. Ankylosing means that the moving parts of the spine stiffen up progressively. AS is one cause of low back pain and stiffness in young men, but women can also develop the condition. The sex ratio in favour of males is 3:1.

In the late 19th century, Vladimir von Bechterew, Adolph Strumpel and Pierre Marie provided descriptions of the disease, which allowed it to be adequately diagnosed. Apart from spinal involvement, AS can affect peripheral joints and the eye.

Conditions such as psoriatic arthritis, Reiter’s disease, and inflammatory bowel disease can be associated with AS.

There is a high (90-95%) preponderance of a particular tissue type called HLA B27. About 7-8% of the general population have this tissue type but this does not necessarily mean that you will develop the disease - it is a definite risk factor. The cause of AS is not known but there is some good evidence that its onset may be linked to a bacterial trigger.

An old saying amongst doctors is that every patient with ankylosing spondylitis has a sad story to tell – a story of vague backache which has been treated for years with this, that and the other, all without benefit.

With the current emphasis on earlier and more accurate diagnosis and the availability of biological agents for treatment, the prognosis for sufferers has improved remarkably.

Dont forget to submit your entries to the Fremantle International Portrait Prize: www.fremantleportraitprize.org.au



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