Understanding Ankylosing spondylitis
What is Ankylosing Spondylitis?
Ankylosis means fusion. Spondylitis means inflammation of the vertebrae. AS thus means a condition associated with inflammation of the spine that if untretad can eventually lead to fusion of the vertebral joints.
What actually happens in Ankylosing Spondylitis(AS)?
AS is characterized by inflammation at areas where a ligament, tendon attaches to a bone. Persistent inflammation can lead to erosion of the bone. The healing takes place with formation of new bone. Eventually the process of erosion and healing with new bone formation leads to fusion of the bones. This leads to restriction of the movement of the spine.
What are the symptoms of Ankylosing spondylitis?
Ankylosing spondylitits is characterized by low backache or buttock ache. The pain is worse in the morning and after rest. It is associated with significant stiffness of the back in the morning. Getting up from the bed, bending down to pick up things in the morning are especially painful and difficult. As time passes and one moves around, the pain and stiffness subsides.
What is the difference between routine low backache and the backache of AS?
Routine backache generally improves with rest and worsens with activity. However, the backache and the back stiffness of Ankylosing Spondylitis worsens with proplonged rest.
Does Ankylosing Spondylitis affect other joints?
Yes. It can affect other joints as well. The common joints affected are the knees and ankles. There can be pain and swelling of these joints.
How is Ankylosing Spondylitis diagnosed?
Apart from the history, imaging of the sacroiliac joints helps in the diagnosis. X ray may show erosion (scalloping) of the sacroiliac joints. If the changes on plain xray are doubtful, the doctor may ask for a CT scan of the sacroiliac joints as it has a better resolution compared to the xray.
However, if the duration of symptoms is short, the X ray may be normal and a MRI can help secure the diagnosis. MRI is the earliest radiologic investigation to pick up the disease process.
CT scan of a patient of Ankylosing spondylitis showing sacroiliac joint erosions.
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