How Ankylosing Spondylitis and Arthritis Are Related

Introduction

Ankylosing Spondylitis (AS) is a type of arthritis that primarily influences the spine. This condition causes inflammation, leading to symptoms such as stiffness and pain that typically begin from the neck and move down to the lower spine. Over time, the vertebrae can fuse, resulting in a rigid backbone. These changes can range from mild to severe, potentially causing a stooped-over posture. Early identification and treatment are crucial in managing stiffness and pain, and they may help decrease or prevent significant deformity. But who exactly is affected by ankylosing spondylitis?

Who is Affected by Ankylosing Spondylitis?

Although AS can occur at any age, it most commonly affects men in their 20s and teens. It is more prevalent in certain Native American tribes and is generally less common and milder in women. Approximately 0.1% to 0.5% of the adult population is affected by AS (Ward et al., 2019). Understanding the demographics of this condition can help in early diagnosis and management.

Manifestations of Ankylosing Spondylitis

The early and most common signs of ankylosing spondylitis include bony fusion, pain, and stiffness. AS may result in an overgrowth of bones, leading to abnormal linking known as "bony fusion." This fusion can significantly impact an individual's ability to perform regular activities, especially affecting the bones of the back, neck, or buttocks. In some cases, the fusion of the ribs to the spine or breastbone can restrict the ability to expand the chest while breathing, which can be a severe limitation (Braun & Sieper, 2007).

Ligaments and tendons can also be affected, resulting in inflammation and pain. For example, tendonitis can cause discomfort in areas such as the Achilles tendon at the back of the ankle. Persistent pain and stiffness lasting over three months, particularly in the lower back and hips, are common symptoms. Spondylitis often begins around the joints where the sacrum connects with the pelvis in the lower back area (Mau et al., 2005).

Systemic Effects of Ankylosing Spondylitis

AS is a systemic disorder, meaning its symptoms are not restricted to the joints. Individuals with this illness may experience a lack of appetite, fever, and fatigue. In rare cases, complications involving the heart and lungs can develop. Eye discomfort is another symptom that occurs in some individuals with spondylitis (Sieper et al., 2009).

Causes and Diagnosis of Ankylosing Spondylitis

The exact cause of ankylosing spondylitis remains unknown; however, there is a strong genetic or familial connection. Many, but not all, individuals with spondylitis carry a gene known as HLA-B27. Although this gene is prevalent in individuals with AS, it is also found in about 10% of people who do not display symptoms of the condition (Brown et al., 2000).

The diagnosis of ankylosing spondylitis is based on several factors, including symptoms, laboratory results, chest measurement during breathing, findings from a physical exam, and X-rays of the pelvis and back. Early diagnosis is crucial for effective management and treatment, helping prevent severe complications (Khan, 2002).

Conclusion

Understanding ankylosing spondylitis, its manifestations, systemic effects, and the importance of early diagnosis and treatment is vital in managing this chronic condition. Ongoing research continues to uncover more about the genetic factors involved and potential new therapies for those affected by AS.

References

• Ward, M. M., Deodhar, A., Akl, E. A., Lui, A., Ermann, J., Gensler, L. S., Smith, J. A., & van der Heijde, D. (2019). American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network 2019 guidelines for the treatment of ankylosing spondylitis and nonradiographic axial spondyloarthritis. Arthritis & Rheumatology, 71(10), 1599-1613.
• Braun, J., & Sieper, J. (2007). Ankylosing spondylitis. The Lancet, 369(9570), 1379-1390.
• Mau, W., Zeidler, H., Mau, R., Majewski, A., & Freyschmidt, J. (2005). Outcome of ankylosing spondylitis in regard to clinical aspects, disease activity, functional aspects, quality of life, and work capacity. Clinical Rheumatology, 24(1), 29-39.
• Sieper, J., Rudwaleit, M., Baraliakos, X., Brandt, J., Braun, J., & Burgos-Vargas, R. (2009). The Assessment of SpondyloArthritis international Society (ASAS) handbook: a guide to assess spondyloarthritis. Annals of the Rheumatic Diseases, 68(Suppl 2), ii1-ii44.
• Brown, M. A., Kennedy, L. G., MacGregor, A. J., Darke, C., Duncan, E., Shatford, J. L., & Wordsworth, B. P. (2000). Susceptibility to ankylosing spondylitis in twins: the role of genes, HLA, and the environment. Arthritis & Rheumatism, 43(10), 2473-2480.
• Khan, M. A. (2002). Update on spondyloarthropathies. Annals of Internal Medicine, 136(12), 896-907.