What Is Ankylosing Spondylitis?

Understanding Ankylosing Spondylitis

This post was written with Consensus AI Academic Search Engine – please read our Disclaimer at the end of this article. Ankylosing spondylitis (AS) is a chronic, immune-mediated inflammatory disease primarily affecting the spine, leading to spinal inflammation and progressive rigidity. It is characterized by inflammatory back pain and can also involve peripheral arthritis and other systemic manifestations1 6. The disease is a form of spondyloarthritis, with interleukin 17 (IL-17) identified as a key inflammatory cytokine in its development1.

Epidemiology

The prevalence of ankylosing spondylitis is approximately 0.1% in the Caucasoid population, indicating it is relatively rare but significant due to its impact on quality of life and physical function5. The disease often begins in early adulthood and is more common in males than females.

Pathophysiology

Ankylosing spondylitis involves chronic inflammation that can lead to new bone formation and ankylosis, particularly in the spine and sacroiliac joints. This process results in reduced spinal mobility and can cause significant functional impairment5 7. The role of regulatory T (Treg) cells and cytokines such as IL-17 and tumor necrosis factor alpha (TNF-alpha) are crucial in the disease’s pathogenesis1 3.

Clinical Manifestations

Patients with ankylosing spondylitis typically experience chronic back pain and stiffness, particularly in the morning or after periods of inactivity. The disease can also lead to extra-musculoskeletal manifestations such as uveitis, psoriasis, and inflammatory bowel disease6. Over time, the inflammation can cause the spine to fuse, leading to a loss of flexibility and a hunched posture.

Diagnosis

Diagnosis of ankylosing spondylitis is based on clinical criteria, including the presence of chronic back pain, reduced spinal mobility, and imaging findings such as sacroiliitis on X-rays or MRI. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Assessment of SpondyloArthritis International Society (ASAS) criteria are commonly used to assess disease activity and response to treatment5 9.

Impact on Quality of Life

Ankylosing spondylitis can significantly affect a patient’s quality of life due to chronic pain, reduced mobility, and the psychological impact of living with a chronic disease. Physical therapy and exercise are recommended to maintain mobility and improve functional status, which can help mitigate some of these effects5 10.

In summary, ankylosing spondylitis is a chronic inflammatory disease that primarily affects the spine, leading to significant physical and functional impairments. Understanding its pathophysiology, clinical manifestations, and impact on quality of life is crucial for managing the disease effectively.

Disclaimer

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