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Ankylosing spondylitis

  Ankylosing spondylitis is a chronic progressive inflammatory disease that primarily affects the spine and involves the sacroiliac joints and surrounding joints. This disease is also known as Marie-strümpell disease, rheumatoid spondylitis, rheumatoid central type, etc., and is now called AS. Since the disease can also affect peripheral joints and is similar to RA in clinical, radiological, and pathological manifestations, it has been considered a variant of rheumatoid arthritis for a long time, known as rheumatoid spondylitis. Considering that patients with AS do not have IgM rheumatoid factors (seronegative) and it is significantly different from RA in clinical and pathological manifestations, the American Rheumatism Association (ARA) finally decided to separate the two diseases in 1963, replacing 'rheumatoid spondylitis' with 'ankylosing spondylitis'.

 

Table of Contents

1. What are the causes of ankylosing spondylitis
2. What complications can ankylosing spondylitis easily lead to
3. What are the typical symptoms of ankylosing spondylitis
4. How to prevent ankylosing spondylitis
5. What laboratory tests are needed for ankylosing spondylitis
6. Dietary taboos for patients with ankylosing spondylitis
7. Conventional methods of Western medicine for the treatment of ankylosing spondylitis

1. What are the causes of ankylosing spondylitis

  Medical science has not yet found a clear cause of the disease, but it is related to heredity (leukocyte antibody HLA-B27 in the human body), immunity, and infection. If there have been patients with this condition in the family, then family members should be checked in advance in order to be able to diagnose early and receive timely treatment.

 

2. What complications can ankylosing spondylitis easily lead to

  More than 30% of patients with ankylosing spondylitis have symptoms such as peripheral joint bursitis, joint swelling and pain with effusion, weight loss, anemia, fatigue, cardiac abnormalities, uveitis of the eye and pulmonary fibrosis in the upper lobe. It should be noted that about one quarter of patients may have concurrent acute iridocyclitis and the risk of blindness, so caution is necessary.
  In addition, due to the spine's inability to bend normally, sexual intercourse is often difficult, and intense sexual intercourse can also worsen joint pain. If combined with the influence of mental stress and endocrine factors, patients will have obvious sexual dysfunction.

3. What are the typical symptoms of ankylosing spondylitis

  Once ankylosing spondylitis occurs, it develops irreversibly, and its course has the following characteristics:

  Inflammation of the spine, hip bone, pelvic coccyx → calcification and rigidity of the bony points and joints → the spine cannot bend and lose elasticity → inflammation and rigidity spread upwards and downwards along the spine.

  After the inflammation subsides slightly, the upper and lower parts of the spine will appear ossified spurs due to adhesion, causing hunchback, stiffness, and pain. In addition to the spine being rigid as iron, patients are also prone to pain due to inflammation of the bones, tendons, and ligaments.

  Most patients with this disease are adults aged 20 to 40. Men are more than women, and many patients develop this condition during military service, leading to the misconception that it is a disease caused by excessive training and injuries in the military. In fact, according to statistics, there are four patients with this condition per thousand people in China, and male patients have more severe disease and a faster course.

4. How to prevent ankylosing spondylitis

  Ankylosing spondylitis has a large difference in the degree of clinical manifestation, with some patients experiencing recurrent and progressive disease, while others remain relatively stationary for a long time, allowing normal work and life. However, the onset age is relatively young, the hip joint is involved early, recurrent attacks of iritis and secondary amyloidosis, delayed diagnosis, untimely and unreasonable treatment, and not persisting in long-term functional exercise have poor prognosis. Although the emergence of biological agents has greatly improved the prognosis of this disease, it is still a chronic progressive disease that is difficult to be completely cured, and long-term follow-up should be conducted under the guidance of a specialist physician.

 

5. What laboratory tests are needed for ankylosing spondylitis

  Ankylosing spondylitis can be diagnosed and confirmed clinically in the following three ways:

  1. Computerized tomography:For patients suspected clinically but not diagnosed by X-ray, CT examination can be performed. It can clearly show the sacroiliac joint space, which is convenient for determining whether the joint space is widened, narrowed, rigid, or partially rigid.

  2. Magnetic resonance and single photon emission computed tomography:American scientists studied 36 patients, 24 of whom had inflammatory low back pain and 12 had low back pain caused by mechanical pressure. Standard X-ray examination showed normal sacroiliac joints. However, when using MRI examination: 54% of patients with inflammatory low back pain and 17% of patients with mechanical low back pain had sacroiliitis.

  3. SPECT examination:38% of inflammatory low back pain cases have sacroiliitis, while no such finding was observed in the mechanical cause group. The positive detection rate of MRI and SPECT was significantly increased. 58% of patients with inflammatory low back pain and 17% of patients with mechanical low back pain have sacroiliitis. Therefore, the researchers believe that MRI and SPECT闪烁造影sacroiliac joint imaging are very helpful for early diagnosis and treatment, and are obviously superior to ordinary X-rays in this aspect, but they are expensive and not recommended as routine examinations.

6. Dietary taboos for patients with ankylosing spondylitis

  Patients with ankylosing spondylitis should avoid cold and raw foods and prefer warm foods such as ginger and wine, which are beneficial for warming the blood vessels, dispelling coldness, and relieving pain; they should eat more nutritious foods such as beef, mutton, and chicken. They can also cook Astragalus, prepared Rehmannia, Angelica sinensis, and Chinese wolfberry with meat and other foods as food therapy (eating meat and drinking soup) and so on.

7. Conventional Methods of Western Medicine for Treating Ankylosing Spondylitis

  Currently, the treatment methods are limited to using drugs to control inflammation and using rehabilitation to maintain joint mobility. To control the progression of the disease and rehabilitation, doctors recommend that patients start from the following details of life:

  1. Maintain good posture, sitting posture, and sleeping posture to avoid the curvature of the spine and exacerbate the hunchback.

  2. Maintain regular and continuous rehabilitation exercises in daily life to soften the stiff areas and maintain joint extensibility. Perform deep breathing, chest expansion, and straightening the trunk to strengthen the back muscles and abdominal flexibility, such as swimming and stretching exercises, to delay the progression of the lesion.

  3. Due to the decreased load-bearing capacity of the patient, it is necessary to avoid heavy loads to prevent the progression of the lesion.

  4. Do not use a lumbar and back brace to prevent the exacerbation of spondylitis.

  5. Avoid sleeping with a pillow and not sleeping on a soft bed when sleeping.

  6. If the back is stiff when getting up in the morning, it is not advisable to take a hot bath to improve it.

  7. More attention should be paid to preventing the onset of the disease during cold and humid seasons.

  8. Taking painkillers and non-steroidal anti-inflammatory drugs prescribed by the doctor can alleviate the patient's pain, and hot compresses are also effective for pain relief.

  9. Once the course of the disease becomes severe to the point of being unable to walk, the doctor will evaluate the patient's condition and consider surgical implantation of an artificial hip joint.

  Ankylosing spondylitis has a destructive effect on the skeletal tissue of the human body, in addition to making people hunchbacked, it can also deform the skeleton and hinder movement; if treatment is delayed, there is a risk of disability. Moreover, this is a physical disability deformation formed after adulthood, the impact on the patient's physical and mental health is self-evident, but patients should never lose heart and give up medical treatment. If treated properly, combined with persistent and appropriate exercise, the progression of the disease can also be slowed down.

Recommend: Spondylitis , Spina anemia , 脊椎结核 , Insufficient blood supply of vertebrobasilar arteries in the elderly , Subacute combined degeneration of the spinal cord in the elderly , Anterior longitudinal ligament ossification

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