Ankylosing Spondylitis


Ankylosing spondylitis is a rare condition that can cause back and neck pain. It is a rheumatic inflammatory disease that affects the spine and sacroiliac joints. This disease is three times more likely to develop in men than in women and it usually occurs between the ages of 20 and 40. Although it primarily attacks the spine (usually the low back first), this chronic and painful disease can also attack other joints, tendons and ligaments, and the chest wall. Though its cause is unknown, ankylosing spondylitis tends to run in families which suggests that genetics plays a role in the development of this disease. A patient is 10 to 20 times more likely to have ankylosing spondylitis if a parent or sibling also has this condition.

Symptoms

Ankylosing spondylitis is a disease that can cause the joints between the vertebral bodies in the spine and the sacroiliac joints (which connect the spine to the pelvis) to fuse together over time. When this happens, patients with ankylosing spondylitis can have difficulty moving their neck freely because the vertebral bodies in the cervical spine have fused in a particular position. Some of the common symptoms for ankylosing spondylitis include a moderate amount of back pain and stiffness (usually over a period of weeks or months). The pain is often worse at night. Many patients say taking a warm shower or performing light exercise often relieves early morning stiffness. While the symptoms of anklyosing spondylitis can last for significant periods of time, the disease is usually characterized by mild to moderate flare-ups followed by periods of almost no symptoms. In severe cases of ankylosing spondylitis, bone spurs on vertebral bodies, and degenerative changes along the spine can press against nerves or the spinal cord, causing numbness, weakness, or pain to develop in the area supplied by those nerves.

Diagnosis

In particularly severe cases, patients may be unable to look above the level of the horizon because their neck has fused in a position of flexion, or they may develop a significant amount of pain from having a hunched over posture. Ankylosing spondylitis is usually diagnosed by taking x-rays of the spine that may reveal characteristic changes along the length of spine where the vertebral bodies have fused together. This radiographic appearance is often called a "bamboo spine", because the x-ray of the spine resembles the pattern on a piece of bamboo. Fusions between the vertebral bodies are not always seen on the x-ray of the spine, especially early in the course of the disease. In this situation, a blood test can suggest that someone has ankylosing spondylitis, because 90% of people who have this disease have a particular marker present on their blood cells called HLA-B27.

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Published: February 23, 2007
Updated: April 24, 2007