Ankylosing Spondylitis

Ankylosing spondylitis (AS) is the prototype spondyloarthropathy and a system disease with inflammation of the axial skeleton, large peripheral joints and fingers, nocturnal back pain, back stiffness, hyperkyphosis, general symptoms, aortitis, conduction disturbances and anterior uveitis. The diagnosis is confirmed by the detection of a sacroiliitis the radiograph (n. D. Übers .: or more MRI). The treatment program consists of NSAID, TNF antagonists and physical measures which maintain the mobility.

The AS comes in men three times more common and usually begins between 20 and 40 years. In first degree relatives of AS patients it occurs 10 to 20 times more frequently than in the general population. The risk of AS is in first-degree with positive HLA-B27 allele 20%. The increased prevalence of HLA-B27 in whites and HLA-B7 in blacks confirms the important role of genetic predisposition. However, the concordance rate in monozygotic twins is only 50%, which underlines the importance of environmental factors. Perhaps an immunologically mediated inflammation plays an important pathophysiological role.

Ankylosing spondylitis (AS) is the prototype spondyloarthropathy and a system disease with inflammation of the axial skeleton, large peripheral joints and fingers, nocturnal back pain, back stiffness, hyperkyphosis, general symptoms, aortitis, conduction disturbances and anterior uveitis. The diagnosis is confirmed by the detection of a sacroiliitis the radiograph (n. D. Übers .: or more MRI). The treatment program consists of NSAID, TNF antagonists and physical measures which maintain the mobility. The AS comes in men three times more common and usually begins between 20 and 40 years. In first degree relatives of AS patients it occurs 10 to 20 times more frequently than in the general population. The risk of AS is in first-degree with positive HLA-B27 allele 20%. The increased prevalence of HLA-B27 in whites and HLA-B7 in blacks confirms the important role of genetic predisposition. However, the concordance rate in monozygotic twins is only 50%, which underlines the importance of environmental factors. Perhaps an immunologically mediated inflammation plays an important pathophysiological role. Classification Most patients with AS (called axial AS) predominantly axial involvement. Some have predominantly peripheral involvement. Among those with axial involvement some have no evidence of sacroiliitis in neutral images. Therefore, some experts AS changed as follows divided: Axial AS: Has predominantly axial involvement and radiographic findings typical of sacroiliitis “Nonradiographic AS”: Clinical similar to the axial AS but without radiographic findings typical of sacroiliitis Peripheral AS: AS with predominantly peripheral participation symptoms and complaints The most common early findings are deep-seated back pain, but the disease can begin in the peripheral joints (especially among women and children), rarely even with acute iridocyclitis (anterior uveitis). Another possible early findings are limited thoracic breathing width due to diffuse Kostovertebralbefall, temperature increase, fatigue, loss of appetite, weight loss and anemia. The deep-seated back pain – often nocturnal and of varying intensity – after taking a relapsing course. It caused morning stiffness, which dissolves through exercise, and paraspinal muscle cramps. A stooped, overhanging posture relieves back pain and muscle cramps; characterized hyperkyphosis is common in untreated patients. In the course often a heavy coxitis developed. In the late stage are a massive hyperkyphosis, the loss of lumbar lordosis and a fixed stooped posture with impaired lung function and inability to lie flat, the consequences. There may be peripheral deforming arthritis, sometimes with the participation of the fingers (dactylitis). Inflammation of the Achilles and patellar tendon can occur. Systemic manifestations are found in about one third of patients. A recurrent anterior uveitis is common and usually speaks at a local treatment; more rarely it comes to a protracted course, with the risk of vision loss. Occasionally, neurological symptoms as a result of Kompressionsradikulitis or sciatica, vertebral fracture or subluxation or cauda equina syndrome can occur. On possible cardiovascular manifestations include aortic insufficiency, aortitis, angina, pericarditis or conduction defects (possibly asymptomatic). Rarely dyspnoea, cough or hemoptysis may develop on the ground of non-tuberculous fibrosis or cavitation of lung upper lobe; cavernous lesions may be secondarily infected with Aspergillus. Very rarely creates a secondary amyloidosis. Rheumatoid nodules are not formed. Diagnostic imaging of Lumbosakralbereichs blood tests (ESR, CRP and blood count) or explicit clinical criteria (modified New York criteria) to an AS v. a. to think if young patients (v. a. male), are striking with nocturnal back pain, hyperkyphosis, limited deep breathing, inflammation of the Achilles or patellar tendon or etiologically unclear anterior uveitis. A positive family history of AS (v. A. The first degree relatives) confirmed the suspicion. ESR, CRP and blood count should be investigated, RF and ANA, however, only in cases of suspected peripheral arthritis or another diagnosis. No laboratory test is conclusive, but suspicions can harden and possible differential diagnoses are excluded. In more of suspected imaging of the Lumbosakralbereichs should be done; the representation of sacroiliitis on X-ray (n. d. Übers .: doubt cases MRI) confirmed the diagnosis. Ankylosing spondylitis DR P. MARAZZI / SCIENCE PHOTO LIBRARY var model = {thumbnailUrl: ‘/-/media/manual/professional/images/c0116639_ankylosing_spondylitis_x-ray_science_photo_library_high_de.jpg?la=de&thn=0&mw=350’ imageUrl: ‘/ – / media /manual/professional/images/c0116639_ankylosing_spondylitis_x-ray_science_photo_library_high_de.jpg?la=de&thn=0 ‘, title:’ ankylosing spondylitis ‘, description:’ u003Ca id = “v38395301 ” class = “”anchor “” u003e u003c / a u003e u003cdiv class = “”para “” u003e u003cp u003eDiese x-ray shows sclerosis between the lumbar vertebrae

Health Life Media Team

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