What is Ankylosing Spondylitis?

Written by Na Hong Wei
Orthopedics
Updated on September 23, 2024
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Ankylosing Spondylitis (AS), where "A" stands for fusion and "S" for spine, refers to the condition where the bones and joints of the spine are fused together. Ankylosing Spondylitis is defined as a chronic inflammatory disease primarily affecting the axial skeleton and major limb joints. It is characterized by fibrosis and ossification of the intervertebral discs’ annulus fibrosus and nearby connective tissues, as well as ankylosis (stiffening) of the joints. It presents as a sterile inflammation occurring in the spine. However, it is not solely limited to the spine as it also involves the axial bones and major limb joints. The pathological hallmark of the disease includes inflammation mainly at the sacroiliac joints and points of attachment to the spine, leading to joint stiffness and calcification of the spinal ligaments and joints. The disease progression begins at the sacroiliac joint, spreading upwards through the entirety of the spine, and eventually stops at the cervical vertebrae. Symptoms start with pain in the early stages, followed by restricted mobility in the intermediate phase, and ultimately leading to deformities of the abdomen and back, culminating in severe hunchback. The exact cause of Ankylosing Spondylitis remains unclear, with various theories proposed but none universally accepted. Additionally, it is categorized under rheumatologic and immunologic disorders.

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Written by Yang Ya Meng
Rheumatology
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What to check for ankylosing spondylitis?

The examination for ankylosing spondylitis mainly includes blood tests. The main components of the blood tests are erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), ANA along with CCP antibodies, and AKA antibodies, and of course, the most crucial test related to the gene - HLA-B27. Imaging exams can include the following: First, an X-ray of the pelvis, or an MRI of the sacroiliac joints. If the disease has been present for a longer time, a CT of the sacroiliac joints can be chosen. If the patient has elevated ESR and CRP, a positive B27, and lesions in the sacroiliac joints, then the diagnosis of ankylosing spondylitis can be confirmed.

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Written by Yang Ya Meng
Rheumatology
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How is ankylosing spondylitis treated?

The treatment of ankylosing spondylitis mainly consists of three parts: The first part is anti-inflammatory and pain relief. For anti-inflammatory pain relief, non-steroidal pain relief medications are commonly chosen, such as slow-release diclofenac sodium tablets and celecoxib capsules. The second part involves the selection of medications to control the disease. Common drugs used to control the condition include sulfasalazine, thalidomide, and methotrexate tablets. The third part includes the most effective, yet most expensive, treatment option: biological agents. Common biological agents used are tumor necrosis factor antagonists. However, before using biological agents, strict screening for diseases such as hepatitis, tuberculosis, and cancer is required. Only after excluding these conditions can the treatment with biological agents be considered.

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Written by Li Jing
Rheumatology
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Ankylosing Spondylitis Test Items

Ankylosing spondylitis is a systemic disease of unknown cause, primarily characterized by chronic inflammation of the axial joints. It mainly affects the sacroiliac joints and leads to bony ankylosis, predominantly occurring in males, especially young males. The disease has a significant familial genetic tendency. The main symptoms are pain or discomfort in the lower back and back, typically occurring at night, accompanied by difficulty turning over. Stiffness is evident in the morning or after sitting for a long time, but symptoms may alleviate after physical activity. In young and middle-aged males showing these symptoms, ankylosing spondylitis should be suspected first. The main diagnostic methods include blood tests for HLA-B27, and imaging such as CT or MRI of the sacroiliac joints to detect any sacroiliitis. Diagnosis primarily relies on the combination of symptoms, HLA-B27 results, and sacroiliac joint CT findings.

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Written by Li Jing
Rheumatology
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What causes ankylosing spondylitis?

Ankylosing spondylitis is primarily an autoimmune disease affecting the axial joints, which may also manifest with extra-articular symptoms. In severe cases, deformities and stiffening of the spine can occur. The cause of the disease is attributed to the interactive effects of genetics and environmental factors, making it a multi-gene inherited disorder. However, for some individuals, it may also be related to infections such as Ureaplasma urealyticum, Shigella, Salmonella, and Escherichia coli in the urinary and genital tracts. These pathogens trigger the body's inflammatory immune response, resulting in tissue damage and contributing to the onset and progression of the disease. There is a notable familial aggregation in the occurrence of this disease.

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Written by Na Hong Wei
Orthopedics
1min 34sec home-news-image

What is Ankylosing Spondylitis?

Ankylosing Spondylitis (AS), where "A" stands for fusion and "S" for spine, refers to the condition where the bones and joints of the spine are fused together. Ankylosing Spondylitis is defined as a chronic inflammatory disease primarily affecting the axial skeleton and major limb joints. It is characterized by fibrosis and ossification of the intervertebral discs’ annulus fibrosus and nearby connective tissues, as well as ankylosis (stiffening) of the joints. It presents as a sterile inflammation occurring in the spine. However, it is not solely limited to the spine as it also involves the axial bones and major limb joints. The pathological hallmark of the disease includes inflammation mainly at the sacroiliac joints and points of attachment to the spine, leading to joint stiffness and calcification of the spinal ligaments and joints. The disease progression begins at the sacroiliac joint, spreading upwards through the entirety of the spine, and eventually stops at the cervical vertebrae. Symptoms start with pain in the early stages, followed by restricted mobility in the intermediate phase, and ultimately leading to deformities of the abdomen and back, culminating in severe hunchback. The exact cause of Ankylosing Spondylitis remains unclear, with various theories proposed but none universally accepted. Additionally, it is categorized under rheumatologic and immunologic disorders.