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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What department should I go to for ankylosing spondylitis?

Ankylosing spondylitis is an idiopathic systemic disease primarily characterized by chronic inflammation of the axial joints, mainly involving the sacroiliac joint. The typical onset age ranges from 10 to 14 years, and it is more common in males. It is not hereditary, but there is a familial predisposition. If there is a family history, and localized pain or discomfort is present, especially if there is difficulty turning over at night, stiffness after waking or after prolonged sitting or standing, which eases with activity, it is important to be alert. This condition falls under rheumatic immune diseases, therefore, it should be managed by a rheumatology immunology department, not orthopedics.

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Written by Yang Ya Meng
Rheumatology
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Is ankylosing spondylitis serious?

Patients with ankylosing spondylitis, if treated actively in the early stages, the condition is not severe. However, if the patient continues to seek irregular and improper medical care, it is possible to develop severe complications such as kyphosis and spinal ankylosis. In severe cases, patients may even self-harm. Therefore, it is advised that patients with ankylosing spondylitis seek treatment early, before the onset of spinal ankylosis. The treatment plan mainly includes non-steroidal analgesics, such as diclofenac sodium sustained-release tablets, medications to control the condition, such as sulfasalazine tablets, and biologic treatments. With the above treatments, the condition of ankylosing spondylitis can be controlled. (Medication use should be under the guidance of a doctor.)

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Written by Li Jing
Rheumatology
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Ankylosing Spondylitis Diagnosis Methods

Ankylosing spondylitis is primarily characterized by involvement of the elbow joints, but it can also be accompanied by extra-articular manifestations such as iritis and pain in the heel, and severe cases may present with spinal stiffness and deformity. The cause of the disease is unclear, but studies suggest it is related to genetic and environmental factors, with a significant familial aggregation. Diagnosis requires a combination of clinical symptoms, blood tests including HLA-B27, and imaging such as CT or MRI of the sacroiliac joints to confirm inflammation or damage to these joints. To diagnose ankylosing spondylitis, these three criteria must be met. The most important factor is the presence of clinical symptoms that persist for more than three months, improve with activity, and do not significantly improve with rest. This is a typical characteristic of ankylosing spondylitis.

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Written by Li Jing
Rheumatology
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Does ankylosing spondylitis have a genetic component?

Firstly, ankylosing spondylitis is a chronic disease that primarily affects the axial joints, and this disease is incurable. It can only be managed with medications to control the progression of the disease, delay the appearance of joint deformities, and reduce disability. This is the main purpose of its treatment. The cause of the disease is also unclear, and it is somewhat related to genetics. If parents have it, the incidence in their children is significantly increased, and there is a phenomenon of familial aggregation. It cannot be considered a hereditary disease, but there is indeed a phenomenon of familial aggregation. Moreover, the incidence of the disease in children is much higher than in families without a history of the disease.

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Written by Yang Ya Meng
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What to do about ankylosing spondylitis pain?

The medications for treating pain in ankylosing spondylitis fall into three major categories: The first category includes non-steroidal anti-inflammatory drugs, such as sustained-release diclofenac sodium tablets. The second category consists of disease-controlling drugs, which are often immunosuppressants, such as methotrexate and sulfasalazine. Third, if patients still experience significant back pain despite using anti-inflammatory analgesics and disease-controlling drugs, biologic agents can be considered. The main biologics currently include tumor necrosis factor antagonists. (Note: The use of medications should be under the guidance of a doctor.)