Ankylosing Spondylitis
(Marie-Strumpell Disease)
Definition |
Causes |
Risk Factors |
Symptoms |
Diagnosis |
Treatment |
Prevention |
Organizations
Definition
Ankylosing spondylitis is a chromic inflammatory disease that causes arthritis of the spine and hips. It can also affect other joints, and can cause inflammation of the eyes, lungs, or heart valves.
Causes
The cause of ankylosing spondylitis is not known. However, most people with ankylosing spondylitis share a common gene marker called HLA-B27. This finding indicates that genes play an important role in the development of this condition.
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.
- Sex: Male
- Age: Adolescent and young adult
- Race: Native Americans and Caucasians of North America and Western Europe
- Family members with ankylosing spondylitis
- Having the HLA-B27 gene marker
- Inflammatory bowel disease
- Ulcerative colitis
- Crohn's disease
Symptoms
The severity of symptoms can vary from mild to very severe.
Common symptoms may include:
- Stiffening and pain (arthritis) of the:
- Lower back
- Sacroiliac joint, where the back and hip meet
- Pain that is often worse at night
- Stiffness that is worse in the morning
- Symptom improvement with exercise or activity
- Occasionally, pain and stiffness in the:
- Knee
- Upper back
- Neck
- Shoulders
- Feet
- In more severe cases, pain and inflammation of the eyes, lungs, or heart valves
Less common symptoms may include:
- Fatigue associated with:
- Loss of appetite or weight loss
- Fever or night sweats
- Numbness (if arthritic spurs compress the spinal nerves)
Diagnosis
The doctor will ask about your symptoms and medical history, and perform a physical exam. Diagnosis is based on common symptoms of ankylosing spondylitis, such as:
- Dramatic loss of flexibility of the lower back and spine (limitation of motion of the low back)
- Pain in the lower back
- Limited chest expansion on taking deep breaths
Tests may include:
- X-rays of the low back and hips to check for characteristic changes
- Occasionally, MRI or CT scan of the involved joints
- Blood tests to check for:
- HLA-B27 gene marker
- Anemia
- Elevated sedimentation rate
Treatment
There is no cure for ankylosing spondylitis. Treatment is aimed at relieving the symptoms.
Treatments may include:
Medications
Drug treatment may include:
- Non-steroidal anti-inflammatory drugs (NSAIDs) to control pain and inflammation
- Joint injections with corticosteroids to control inflammation
- Other medications to relieve pain or inflammation
Physical Therapy
Techniques to prevent progression and worsening of symptoms may include:
- Learning proper posture and the best positions for sleeping
- Daily exercise, such as:
- Abdominal and back exercises (to decrease back stiffness and maintain good posture)
- Stretching exercises
- Swimming exercises
- Breathing exercises (in cases where the lungs are affected)
Surgery
In severe cases, hip or joint replacement surgery may be needed to relieve pain and restore mobility.
Prevention
There are no guidelines for preventing ankylosing spondylitis because the cause is unknown.
Organizations
Spondylitis Association of America (SAA)
http://www.spondylitis.org
National Ankylosing Spondylitis Society (NASS)
http://www.nass.co.uk
SOURCES:
The Merck Manual of Medical Information—Home Edition. Simon and Schuster, Inc., 2000.
American College of Rheumatology
University of Washington Orthopedics & Sports Medicine Department
Last reviewed October 2001 by Medical Review Board
