Spondyloarthritis is a collective group of related inflammatory rheumatic diseases. Learn more from Singapore General Hospital (SGH) Department of Rheumatology and Immunology.
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ANKYLOSING SPONDYLITIS (AS)
Ankylosing spondylitis is a long-term disease that affects the joints in the spine, pelvis and, often, the peripheral joints such as hips, knees, ankles and feet as well. The main problem is chronic inflammation that may eventually cause the spine to fuse together.
The condition usually starts with low back pain that is worse at night, in the morning, or after prolonged inactivity, and tends to improve with exercise. Limited expansion in the chest may occur as a result of inflammation of the joints between the ribs. As the disease progresses, any portion of the spine may be affected.
The disease affects more males than females although females can also be affected. It tends to begin between the ages of 20 and 40. Risk factors include having an affected family member and male gender.
DIAGNOSIS BASED ON SYMPTOMS
It is important that you give a detailed history of your symptoms to your doctor as, often, the diagnosis can be made based on your symptoms. The specific symptoms of Ankylosing spondylitis include stooped posture and back pain that is worse at night, in the morning or after inactivity.
Neck, hip and heel pain, pain and swelling in the shoulders, knees and ankles, stiffness in the back, limited chest expansion and range of motion involving the spine and hips, fatigue, mild fever, loss of appetite, loss of weight are also symptoms. Other uncommon complications include eye inflammation, lung fibrosis and disease of the heart valves.
Psoriasis is a scaly rash that can affect any part of the body, but most frequently the elbows, knees and scalp. In about 5-10 per cent of patients with psoriasis, arthritis may also occur, giving rise to psoriatic arthritis. Apart from the involvement of the spine, pelvis and joints, psoriatic arthritis is often accompanied by changes in the finger nails and toe nails such as the appearance of small pits.
Enteropathic arthritis is a form of spondyloarthritis that is associated with inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis, which typically causes inflammation of the intestines. About 1 in 6 people with inflammatory bowel disease will develop enteropathic arthritis affecting the spine and joints.
Reactive arthritis refers to a type of spondyloarthritis that may be triggered by certain germs which cause gastroenteritis or urinary tract infections. Reiter’s syndrome is a form of reactive arthritis which may also affect the eyes and the skin.
Not all patients have classic signs and symptoms that fit neatly into one of the categories outlined above, especially at the start of the illness. In such cases, the term undifferentiated spondyloarthritis may be used.
Read on for treatment and tips to care for spondyloarthritis-related conditions.