Ankylosing spondylitis (AS) is a systemic disease involving multiple organs throughout the body, with a genetic predisposition of value and an incidence of about 1.5%. There are two types of the disease: primary and secondary. Primary ankylosing spondylitis usually develops at the age of 10-20 years, with a peak of 30-40 years. Secondary ankylosing spondylitis can occur at any age. In earlier years, the incidence of the disease was thought to be more common in men than in women, about 10:1, but in recent years studies have found no significant difference in the incidence of the disease by gender. Male patients more often present with progressive spinal lesions and hip lesions. In women, peripheral joint involvement is more common, and the clinical symptoms are mild and easily confused with other diseases, so the patients seen clinically are usually men who are “old before their age, waist first”, bending over, flexing the hip, extending the buttocks back, and having a dull facial expression. Very characteristic. Often a glance can be seen. At this time HLA-B27 examination is just the process, because at this time the sacroiliac joint has fused, the lumbar vertebrae between the bone bridge also appeared. Yin Jiguang, Department of Bone and Joint, Affiliated Hospital of Shandong University of Traditional Chinese Medicine
Since this disease is characterized by the phenomenon of “tendon terminal inflammation”, the soft tissues around the joint are extensively involved and are prone to heterotopic ossification. In this patient, the muscle fibrous changes are obvious, like cords. It does not bleed easily when cut. This is distinctly different from the muscle changes seen in rheumatoid arthritis. In ankylosing spondylitis, the patient is young, active, and has limited lumbar movement, all of which increases the amount of mechanical movement of the hip joint and increases wear and tear, so these patients often have severe wear and tear of the femoral head at a very young age, necrosis, and forced hip joint, etc. As a result, hip flexion deformity (fibrous or bony stiffness of the joint) occurs, and the patient is unable to see eye level. Standing and walking are abnormally difficult. Patients may have been seen in immunology at this point, hoping that internal medication would solve the problem, and often only consult an osteoarthritis department when it has progressed to an unusually severe level. There is only one path left to take with joint replacement. So to our friends with ankylosing spondylitis, we say.
Love your joints, love your hips.