Ankylosing spondylitis or ankylosing spondylitis - a chronic disease of the joints of spine and joints of other sites of the inflammatory nature. Thus there is limited mobility of joints due to ankylosis (fusion articulated in the joint ends of bones), fusion and calcification (deposition of calcium salts) ligaments.
The disease was first described by Bekhterev in the late nineteenth century. It is now established that the development of the disease is very important genetic predisposition. The disease is chronic. The disease onset between the ages of 15 to 30 years.
The first signs of joint damage detected in the sacroiliac joints. First, inflammatory manifestations occur on the inside (synovial) joint in the hull of the sacroiliac joints, spinal joints or costovertebral joints, at least in the joints of the extremities. As a result of inflammation increases the amount of synovial fluid. In the joint cavity is delayed protein formed as a result of inflammation - fibrin.
Gradually the inflammation goes on the cartilage of the joint. Inflammatory changes of the cartilage breaks down, symphysis is formed in the joint, which initially consists of soft tissue, bone union was formed then ends - ankylosis. The joint loses its mobility. The disease develops slowly. In the beginning, pain in the sacrum, the spine. They may be aching, dull. Often the pain occur during the second half of the night or the morning. Pain in other joints occur less frequently, and usually are less severe. In the morning, patients reported difficulty in the beginning of the movement, which gradually passes. This is a symptom of morning stiffness.
Gradually, the inflammatory process develops further. Inflammation of the sacroiliac joint pain is manifested in the buttocks. Give pain in the hip, knee, rarely in the drumstick. Motion in the lumbosacral spinal cord are reduced in volume. When the inflammation spreads to the spine, thoracic spine, the patient has pain in the thoracic spine radiating to the course of the intercostal nerves. This is manifested symptoms of intercostal neuralgia.
The inflammatory process has spread to the cervical spine, causing pain in the neck, extending to the shoulder, arm. Some patients develop symptoms of vertebro-basilar insufficiency. It appears dizziness, stagger when walking, headaches. The defeat of the peripheral joints is less common. Usually takes place a long time. But can also occur in ankylosis of the knee, hip, leading to loss of joint function.
There are four forms of ankylosing spondylitis:
The central form. This form shows only the defeat of the spine. It develops slowly, imperceptibly to the patient. Pain in the rump at first appear, then climb up the spine. The pain intensified by movement and load. There are often night pain. Gradually, the patient's posture changes: increased curvature of the cervical spine, convex forward, and the thoracic spine convex back. The patient's head leans forward, his chin close to the sternum. In the thoracic spine is bent and chest respiratory movements are restricted. In the later stages of the disease in the spine movement is limited considerably. The patient developed asthma, muscle spasms, increased blood pressure. All this is accompanied by pain in all parts of the spine.
Rizomelicheskaya form. In this form of the disease is accompanied by a lesion of spinal cord damage of large joints. Most often suffer from shoulder and hip joints. The disease also develops gradually. Depending on the affected joint pain occur in the buttocks, thigh, hip, groin and sent to a knee or shoulder, upper arm radiating pain in the arm. The peripheral shape. When the peripheral form of ankylosing spondylitis the first signs of disease appear in the sacroiliac joints. Then, several months or even several years, developed inflammation of the knee, ankle joints. In developing joint arthrosis deformans, close to the joints of muscle contractures. This form is more common in adolescents. Scandinavian form of ankylosing spondylitis. This form is similar to the peripheral, but unlike her suffer even more small joints. This joints of hands and feet. Joint pain with this form of disease slack.
Ankylosing spondylitis is accompanied by visceral. Cardio-vascular system - is myocarditis (inflammatory disease of the heart muscle), inflammation of the aortic valve. If kidney disease is developing a serious condition - renal amyloidosis. Eye involvement manifests iritis, iridocyclitis.
Diagnosis of ankylosing spondylitis is based on the clinical picture of disease, X-ray examination, special blood test.
Treatment of ankylosing spondylitis mainly symptomatic. It is aimed at reducing pain, reducing inflammation. For this purpose non-steroidal anti-inflammatory drugs (indomethacin, reopirin, diclofenac). In severe and rapid course of illness used adrenal hormones, immunosuppressants. Assigned to physiotherapy, physiotherapy, a spa treatment. In severe forms of joint damage, surgery is used (total joint replacement) surgery on the spine.