Ankylosing spondylitis is a chronic progressive inflammatory disease of the spine that affects the sacroiliac joints, synapses, nearby ligaments and large joints near the trunk, resulting in fibrous or bony ankylosis and deformity. It used to be considered a central form of rheumatoid arthritis, but is now considered to be distinct from rheumatoid arthritis. The disease is negative for rheumatoid factors and is a seronegative disease. The etiology is not known. The incidence of the patient’s relatives is 20-30 times higher than that of the normal population, and about 96% of patients contain the serum histocompatibility antigen HLA-B27. Clinical manifestations 1. Patients are mostly male young adults, more than 70% between the ages of 15-30. 2. The onset of the disease is slow, the early symptoms are not obvious, and the localization is not clear. Low back pain is often felt, and the inflexibility of lumbar activities is gradually felt, which is obvious in the morning and improves after activities, but inflexible after sitting for a long time. The symptoms get worse day by day and develop upward. 3.The joint pain first appears in the iliac joint, it may occur first on one side, then on the opposite side, or it may occur bilaterally at the same time. There is pressure pain at the sacroiliac joint, and the sacroiliac joint test is positive. 4.Lumbar pain below the spine, stiffness of the lumbar area and inconvenience in moving is the early symptom, gradually developing to the thoracic spine, such as when the rib joints are involved, there is poor breathing, band-like chest pain, and severe pain in the spine when coughing and sneezing. When the spine develops to the cervical spine, it is difficult to turn the head and the whole spine is completely stiff. Due to the stronger flexors than extensors and the patient’s posture of curling the trunk, the spine has a rounded hunchback deformity. 5. Some patients have unilateral or bilateral hip pain, and over time, hip movement is limited and flexion is tonic. The incidence of hip joint is about 38-55%. 6. 30-40% of patients may have acute iritis. Diagnosis basis 1. According to the New York clinical diagnostic criteria. First of all, sacroiliac joint X-ray changes are divided into 5 grades: “Grade 0: normal; Grade I: suspicious; Grade II: slight abnormality, limited bone erosion or osteosclerosis, no change in joint space; Grade III: moderate abnormality, obvious bone erosion and sclerosis, joint space change; Grade IV: severe abnormality, already ankylosing. 2. Diagnostic criteria: (1) the lumbar spine is restricted in anterior pitch, posterior extension and lateral bending; (2) symptoms or pain in the thoracolumbar segment or lumbar spine; (3) respiratory thoracic expansion at the level of the 4th rib space only or less than 2.5 cm. 3. Definite ankylosing spondylitis: (1) grade III-VI bilateral sacroiliac arthritis plus at least one of the above criteria; (2) grade III-IV or grade II bilateral sacroiliac arthritis plus the 1st criteria or plus criteria 2 and 3. 4. Possible ankylosing spondylitis: Grade III-IV bilateral sacroiliac arthritis without any of the criteria. 5. may have mild anemia, increased sedimentation, 90% HLA-B27 antigen positive. 6. early generalized osteoporosis of the spine, progressive accessory obscuration, subchondral bone sclerosis, straightening of the spine, and bamboo-like changes of the spine. How to treat: Treatment principles 1. Patients with ankylosing spondylitis have significantly moderated lesions after the age of 35, and early treatment can yield good results. Early in the anti-inflammatory pain and analgesic drugs and moist heat external control of symptoms, early correction and prevention of deformity of functional exercise, and persistent. 2.Adrenal cortical steroids can be used when necessary. 3, in order to prevent deformity, in the acute pain period, available plaster undershirt, lower limb traction and other methods of treatment. 4, late stage deformity ankylosis, should be performed after the lesion is stationary orthopedic surgery to improve function. The operations often performed are spinal osteotomy, total hip arthroplasty and supracondylar femoral osteotomy. 5.Radiotherapy can quickly relieve pain, but cannot stop the development of lesions, and may induce leukemia or fibrosarcoma and other malignant tumors, so it should be used with caution. The principle of medication 1.Anti-inflammatory pain and Protaxon are more effective. The anti-inflammatory pain is 100-200 mg per day, divided into 3-4 oral doses. After the symptoms are controlled, reduce to 50-100 mg maintenance. Pertussisone 100-200 mg daily. 2. Aspirin, about 3 grams daily. Pay attention to side effects, especially bone bleeding and bone marrow suppression. To reduce gastrointestinal side effects, enteric aspirin is available. 3, prednisone anti-inflammatory and analgesic effect fast. It can be applied when the effect of anti-inflammatory and analgesic drugs is not satisfactory. The daily dosage should not exceed 20 mg. 4. Azathioprine is effective and is more effective if a patient with spondylitis is combined with psoriasis. The dosage is 50-100 mg per day.