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Ankylosing spondylitis


Definition:

Ankylosing spondylitis is a long-term type of arthritis. It affects the bones and joints at the base of the spine where it connects with the pelvis.

These joints become swollen and inflamed. Over time, the affected spinal bones join together.

Alternative Names:

Spondylitis; Spondyloarthropathy

Signs and tests:

Tests may include:

  • CBC
  • ESR (a measure of inflammation)
  • HLA-B27 antigen (which detects the gene linked to ankylosing spondylitis)
  • X-rays of the spine and pelvis
  • MRI of the spine
Treatment:

Your doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce swelling and pain.

You may also need stronger medicines to control pain and swelling such as:

  • Corticosteroid therapy (such as prednisone)
  • Sulfasalazine
  • Methotrexate TNF-inhibitors (such as etanercept, adalimumab, infliximab, golimumab)

Surgery may be done if pain or joint damage is severe.

Exercises can help improve posture and breathing. Lying flat on your back at night can help you keep a normal posture.

Expectations (prognosis):

The course of the disease is hard to predict. Symptoms may come and go at any time. Most people are able to function unless they have a lot of damage to the hips.

Rarely, people may have problems with:

  • Abnormal heart rhythm
  • Scarring or thickening of the lung tissue
  • The aortic heart valve
  • Swelling of the eye
  • Inflammation in the large intestine (colitis)
Calling your health care provider:

Call your health care provider if:

  • You have symptoms of ankylosing spondylitis
  • You have ankylosing spondylitis and develop new symptoms during treatment
References:

Yu D, Lories R, Inman RD. Pathogenesis of ankylosing spondylitis and reactive arthritis. In: Firestein GS, Budd RC, Gabriel SE, et al, eds. Kelley's Textbook of Rheumatology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 74.

Inman RD. The spondyloarthropathies. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011: chap 273.

Sidiropoulos PI, Hatemi G, Song IH, et al. Evidence-based recommendations for the management of ankylosing spondylitis: systematic literature search of the 3E Initiative in Rheumatology involving a broad panel of experts and practising rheumatologists. Rheumatology (Oxford). 2008. 47(3):355-61.


Review Date: 4/20/2013
Reviewed By: Gordon A. Starkebaum, MD, Professor of Medicine, Division of Rheumatology, University of Washington School of Medicine. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.

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