Ankylosing spondylitis may affect more than the spine. The disease may inflame joints in the pelvis, shoulders, hips and knees, and between the spine and ribs. People with AS are more prone to spinal fractures (broken vertebrae).
The areas most commonly affected are: The joint between the base of the spine and the pelvis. The vertebrae in the lower back. The places where tendons and ligaments attach to bones, mainly in the spine, but sometimes along the back of the heel.
Ankylosing spondylitis is a type of arthritis that causes inflammation in the joints and ligaments of the spine. It may also affect peripheral joints like the knees, ankles, and hips. Normally, the joints and ligaments in the spine help us move and bend.
The most common symptoms are intermittent flare-ups of spinal pain and stiffness. However, the disease can also affect other joints, as well as the eyes and the intestines. In advanced AS, abnormal bone growth or calcification of the ligaments of the vertebral bodies of the spine may cause the joints to fuse.
"Fatigue from inflammation in ankylosing spondylitis can feel like you have the flu. You can ache all over," says Rochelle Rosian, MD, the director of regional rheumatology at the Cleveland Clinic in Ohio. “That's because inflammation affects your whole body, not just your joints.”
Types of AS Flares
Generalized flares are more severe and may affect multiple parts of the body. In addition to the above symptoms, they also include flu-like illness (fever, sweating); hot, burning joints; muscle spasms; and more sensitivity.
Between 5 and 10% of cases of ankylosing spondylitis (AS) are associated with inflammatory bowel disease (IBD), either Crohn's disease or ulcerative colitis. A much larger percentage of AS patients have subclinical gut inflammation manifested either by endoscopic findings or by histology.
Osteoporosis and spinal fractures
In AS osteoporosis can develop in the spine and increase your risk of fracturing the bones in your backbone. The longer you have the condition, the more this risk increases. If you do develop osteoporosis, you'll usually need to take medicine to help strengthen your bones.
Spondylosis can lead to spinal stenosis, which is a narrowing of the spinal canal. As a result, the spinal cord and/or spinal nerve roots can become compressed (pinched). For example, the cervical spinal cord can be affected by compression from spondylosis. This is called cervical spondylotic myelopathy.
The first human leukocyte antigen (HLA) haplotype association with human inflammatory disease was discovered in 1972, correlating HLA-B27 with ankylosing spondylitis. This remains one of the strongest known associations of this disease with HLA-B27.
Ankylosing spondylitis causes chronic pain that can come and go. You might experience periods of flares and stiffness, and other times when you don't feel pain as acutely. The symptoms may ease up or disappear for a period of time, but they ultimately return.
Redness, pain, and irritation of the eyes can be symptoms of ankylosing spondylitis. Low back pain and stiffness are the hallmarks of ankylosing spondylitis (AS), but they may not be the first or only symptoms of this inflammatory type of spinal arthritis.
"B27 disease" is a new autoimmune disease that afflicts millions of people throughout the world. "B27 disease" occurs in individuals who have ankylosing spondylitis (AS) or preankylosing spondylitis and/or uveitis and are also positive for HLA-B27.
Ankylosing spondylitis is a form of reactive arthritis following Klebsiella infection, usually occurring in an HLA-B27-positive individual.
The inflammation usually is felt at the sites where ligaments and tendons attach to the bone. These sites are tender to touch and sometimes called “hot spots.” The heel and the back of the foot are common sites for tender spots, which can cause difficulty in standing and walking.
Ankylosing spondylitis can affect the way your brain works. It can cause problems with thinking, remembering, and concentrating. The effect can worsen over time and prevent you from taking care of yourself.
Ankylosing spondylitis (AS) is an inflammatory condition that primarily causes back pain from damage to the spinal joints. AS can spread to other joints too—most commonly, the hips. 1 However, it can also affect the knees and ankles, leading to leg pain.
Ankylosing spondylitis (AS) can make your back stiff and achy. And it can feel even worse if you sit for a long time.
A physical examination for ankylosing spondylitis often also includes the following: Schober Test: Limited motion in the lumbar spine is an AS symptom. The Schober test measures the degree of lumbar forward flexion as you bend over as though touching your toes. Limited motion usually warrants an X-ray.
Diagnosis of Ankylosing Spondylitis
Delayed diagnosis is common because symptoms are often attributed to more common back problems. Musculoskeletal imaging, specifically MRI, plays an important role in early diagnosis and monitoring of ankylosing spondylitis.