Ankylosing spondylitis (AS;) is a chronic progressive inflammatory disease that primarily affects the spine and can involve the sacroiliac and peripheral joints to varying degrees. The disease is also known as Marie-strümpell disease, Von Bechterew disease, rheumatoid spondylitis, deforming spondylitis, rheumatoid central type, etc. It is now called AS. AS is characterized by inflammation and ossification of the spinal joints and ligaments of the lumbar, cervical, and thoracic segments and the sacroiliac joints, with frequent involvement of the hip joint and inflammation of other peripheral joints. The disease is generally rheumatoid factor negative, so it is collectively classified as a seronegative spondylosis with Reiter’s syndrome, psoriatic arthritis, and enteropathic arthritis.
The understanding of this disease continues to improve, and it was found that this disease is different from rheumatoid arthritis in terms of age of onset, gender, location, lesion characteristics, and various laboratory tests. In 1963, the International League Against Rheumatism named the disease ankylosing spondylitis.
Ankylosing spondylitis involves not only the spine, but also the joints of the hip, knee, ankle, wrist, shoulder and other extremities.
Diagnosis of ankylosing spondylitis
Based on the medical history, inflammatory spondylosis should be considered with the following manifestations.
① low back discomfort appearing insidiously ;
② Age <40 years;
③ persisting for more than 3 months;
④ stiffness in the early morning;
⑤ Improvement in symptoms with activity. With the above medical history and signs of sacroiliac arthritis on X-ray, the diagnosis of spondylosis is confirmed; further exclusion of psoriasis, inflammatory bowel disease or Reiter’s syndrome arthritis will lead to the diagnosis of primary AS, rather than waiting until the spine is clearly ankylosed to make a definitive diagnosis.
The current commonly used clinical diagnostic criteria for AS are the New York diagnostic criteria proposed in 1965.
1. The lumbar spine is restricted in three directions: forward flexion, lateral bending, and backward elevation;
2, pain or history of pain in the lumbar spine or low back for more than 3 months;
3. Restricted expansion of the thorax, measured at the level of the 4th intercostal space, with expansion ≤ 2.5 cm.
According to the above clinical criteria and grading of sacroiliac arthritis x-ray changes.
(1) Confirm the diagnosis of AS as.
①Bilateral sacroiliitis grade III or IV with at least one of the above clinical criteria;
② unilateral sacroiliac arthritis grade III or IV, or bilateral sacroiliac arthritis grade II, and with clinical criteria item I, or with clinical criteria item 2, item 3.
(2) Suspected AS is: bilateral sacroiliac arthritis grade III or IV, but does not have any of the clinical criteria.
Treatment.
1.Non-steroidal anti-inflammatory drugs
2.Sulfasalazine
3.Anti-rheumatic drugs
4.Pay attention to nutrition, mainly to keep warm and avoid getting cold
5.Eat less chili