Ankylosing spondylitis

Ankylosing spondylitis (AS) is a chronic inflammatory disease that primarily affects the spine, causing pain, stiffness, and fusion of the joints in the spine. It belongs to a group of conditions known as spondyloarthropathies, which are characterized by inflammation in the joints and entheses (the sites where ligaments and tendons attach to bones).

The exact cause of ankylosing spondylitis is not fully understood, but it is believed to involve a combination of genetic and environmental factors. The HLA-B27 gene is strongly associated with the development of AS, although not all individuals with the gene will develop the condition. It is thought that an abnormal immune response triggered by an environmental factor, such as a bacterial infection, may lead to the inflammation observed in AS.

AS typically begins in early adulthood, often affecting the lower back and sacroiliac joints initially. Over time, the inflammation can spread to other areas of the spine, leading to stiffness and limited mobility. In severe cases, the vertebrae may fuse together, resulting in a rigid spine. Other joints, such as the hips, shoulders, and knees, can also be affected, causing pain and reduced function.

Diagnosis of ankylosing spondylitis is based on a combination of clinical symptoms, physical examination, blood tests, and imaging studies, such as X-rays and magnetic resonance imaging (MRI). While there is no cure for AS, treatment aims to manage symptoms, reduce inflammation, and prevent or delay complications. Nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, exercise, and lifestyle modifications are commonly used to improve pain and maintain flexibility. In more severe cases, disease-modifying antirheumatic drugs (DMARDs) and biologic agents may be prescribed to control inflammation.

Regular monitoring and management of ankylosing spondylitis can help individuals maintain a good quality of life, minimize pain, and preserve joint function. It is important for individuals with AS to work closely with their healthcare team to develop a personalized treatment plan and make appropriate lifestyle adjustments to manage the condition effectively.

For how ankylosing spondylitis can affect the foot, see:
Impaired Gait in Ankylosing Spondylitis
Tarsal involvement in ankylosing spondylitis
How to diagnose ankylosing spondylitis of the foot?

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