Ankylosing spondylitis (Bechterew’s disease)

Bechterew's diseaseLesions within the musculoskeletal system can have very different substrate. In the case of ankylosing spondylitis responsible for the development of the disease is a genetic mutation. Because it causing degeneration primarily affects men between 20 and 30 years of age.

Although the development of the disease is caused by a defective Bechterew gene, it is classified as autoimmune diseases. Degenerative changes primarily affect the connective tissue, especially the joints, ligaments and intervertebral sacroiliac joints. The development of the disease leads to excessive stiffness of ossification and ligaments, which in turn makes it difficult to move very seriously lower limbs.

Symptoms

The disease is progressive, and the first symptoms are rarely combined with a degenerative disease. First, the patients teases weakness, malaise, and loss of appetite. With time, there is asymmetrically distributed pain in the sacro-iliac radiating to the buttocks and the back of the thigh. It becomes especially noticeable at night or after a long jamming. When the disease is more advanced pain moves to the vicinity of thoracic and cervical. Some of the patients are pain in the heels, stiffness and pain in the ribs.

Ankylosing spondylitis leads to changes not only in the skeletal system. This condition favors the recurrent inflammation of the iris, uveitis, and the ascending aorta. Patients with ankylosing spondylitis are more likely to suffer from mitral or aortic valve, as well as inflammation of the prostate and bowel. They are also at greater risk of lung disease (e.g., pulmonary fibrosis) and amyloidosis (a condition characterized by the deposition of proteins in the body).

Bechterew’s disease was diagnosed on the basis of two types of criteria: clinical and radiological. For the first of these includes:

– Pain in the cross-section of the lumbar, maintaining a minimum of three months, which disappeared after physical activity

– Limited mobility of the lumbar spine

– Reduced mobility in the chest

Radiological criterion includes bilateral inflammation of the sacroiliac joints. The presence of all the clinical features or only the last of the criteria does not leave any doubt.

Treatment

The condition can lead to permanent disability, because next to pharmacological treatment to alleviate inflammation (corticosteroids, immunosuppressive drugs) and pain needed physiotherapy and NSAIDs (naproxen, meloxicam, diclofenac). Long ingesting drugs are also associated symptoms from the gastrointestinal tract, such as diarrhea and abdominal pain.

A huge part of the patient also needs canes or crutches to be able to move independently.