How is ankylosing spondylitis diagnosed?

Written by Li Jing
Rheumatology
Updated on September 24, 2024
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Ankylosing spondylitis is an autoimmune disease that cannot be cured but can be managed primarily through medication. Its main typical symptoms include stiffness in the neck or pain in the lower back, with the pain becoming more apparent when at rest or after sitting for a long time. Symptoms tend to improve with movement. A typical occurrence is pain that awakens the patient at night. Peripheral joints like the knee joint and heel can also be affected. However, the main symptoms are stiffness in the neck and pain in the lower back. Diagnosing ankylosing spondylitis requires combining symptoms with a positive B27 blood test result, and imaging tests such as CT or MRI of the sacroiliac joints, showing signs of sacroiliitis, narrowing or damage in the sacroiliac joint space, to confirm the diagnosis.

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Written by Li Jing
Rheumatology
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Can people with ankylosing spondylitis work out?

Ankylosing spondylitis is an autoimmune disease that cannot be cured. It can only be managed with medication to control the condition, delay the onset of joint deformities, and reduce the rate of disability. Lifestyle changes are also a part of the treatment, including quitting smoking and drinking, and avoiding carbonated beverages as they can exacerbate bone loss. Additionally, regular exercise is important, with swimming being the best option. Swimming not only exercises the limbs and improves muscle coordination but also reduces joint wear and tear, making it the ideal form of exercise. For patients who cannot swim, other forms of exercise such as walking or running are also beneficial for fitness.

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Written by Na Hong Wei
Orthopedics
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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.

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Written by Li Jing
Rheumatology
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Does ankylosing spondylitis cause buttock pain?

Ankylosing spondylitis may cause buttock pain. It primarily affects the axial joints, and can be accompanied by extrarticular manifestations. This condition leads to stiffening and deformity of the spine, and it cannot be cured, only managed with medication to slow the progression of the disease, delay joint deformity, improve quality of life, and reduce disability rates. Its clinical manifestations vary widely, and its onset is often insidious. Men are more commonly affected and tend to experience more severe symptoms. The most common symptoms include stiffness in the neck or pain in the lumbar and back areas. However, some people may experience pain in the lower back, accompanied by morning stiffness, or alternating pain in the buttocks, or radiating pain from the groin to the lower limbs. This pain is often worse at night or after prolonged sitting, but symptoms can lessen after activity.

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Written by Li Jing
Rheumatology
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Does ankylosing spondylitis hurt?

Ankylosing spondylitis primarily targets the axial joints, manifesting as a chronic autoimmune disease. The most common clinical symptoms include stiffness in the neck and pain in the lumbar and back regions, areas particularly associated with axial joint involvement, predominantly affecting the spine. Additionally, symptoms can also appear in areas outside of the joints, such as pain in the peripheral joints, heels, wrists, and shoulders. Moreover, some individuals may experience eye inflammation, including recurrent uveitis and corneal ulcers. While spinal pain, neck stiffness, and lumbar or back pain are the most commonly observed clinical manifestations, hip joint pain is also frequently noted.

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Written by Li Jing
Rheumatology
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Can people with ankylosing spondylitis have children?

Firstly, ankylosing spondylitis is an autoimmune disease and is chronic. This disease cannot be cured; rather, it is managed long-term through medications to alleviate symptoms, control the progression of the condition, and delay the onset of joint deformities, which is the main purpose of treatment. This disease is not hereditary, but there is a clear phenomenon of familial aggregation. For instance, if one or both parents have it, the incidence in their children is over 50%. Patients with ankylosing spondylitis can have children, but there is a very high probability that their children will also suffer from the disease. Additionally, it is advised not to conceive while on medication during the treatment period; one must stop taking the medication for more than three months before considering pregnancy.