What is ankylosing spondylitis (AS)?

Ankylosing spondylitis (AS) is a form of arthritis. It is an inflammatory disease that mainly affects the joints and ligaments of the spine, but can affect other joints as well. This inflammation can result in chronic, severe pain, and stiffness. The onset of symptoms is usually in adulthood.
Over time and in severe cases, ankylosing spondylitis can cause some of the vertebrae in your spine to fuse. This process is called ankylosis. Ankylosis is the formation of new bone. The new bone causes the vertebrae to grow together and become fixed/immobile. This rigidity and loss of flexibility can result in having a hunched-over posture. 
Since ankylosing spondylitis is a systemic disease, it is possible for it to affect other joints and other parts of the body - even organs. Some other joints that may be affected are the hips, shoulders, ribs, hands, feet, heels, and knees. Breathing in deeply may become difficult if the ribs are involved. The eyes may also be affected and become inflamed. This is called iritis or uveitis. In rare cases, the lungs and heart are affected.  
Risk factors
  • Family history of ankylosing spondylitis
  • Sex: Ankylosing spondylitis is more common in men
  • Age: Onset is usually late adolescence or early adulthood
  • Genetics: Having the HLA-B27 gene puts you at increased risk but not everyone with the gene will develop the disease. 
  • Race/ethnicity: Ankylosing spondylitis is more common in Caucasian, Hispanic, and Asian populations 
When diagnosing ankylosing spondylitis, your doctor will perform a complete medical history and physical exam. The range of motion and flexibility of your spine and other joints will likely be checked, and your doctor will want to know about the characteristics of the symptoms and pain you are experiencing. Your doctor may also see if you have any problems with breathing deeply and chest expansion to see if your ribs may be involved. 
Some tests that may be done to diagnose ankylosing spondylitis include:
  • Imaging tests: X-rays and magnetic resonance imaging (MRI) scans are often done when diagnosing ankylosing spondylitis. These tests are done to detect any changes in the bones and joints. 
  • Lab tests: Blood can be tested for inflammation markers. Genetic testing can also be done to test for the HLA-B27 gene that is often in people with this disease. 
There is no cure for AS. Treatment mainly focuses on relieving symptoms and preventing complications and deformity. The earlier that treatment and interventions are performed the better the prognosis.
Common treatment methods and medications include:
  • NSAIDs
  • TNF (tumor necrosis factor) blockers
  • Interleukin 17 inhibitor
  • Physical therapy
  • Corticosteroids
  • Disease modifying anti-rheumatic drugs (DMARDs)
  • Surgery 
  • In American Caucasians with ankylosing spondylitis, 95% of them have the HLA-B27 gene
  • 6-10% of the entire population of people with ankylosing spondylitis (in North America) have the HLA-B27 gene
  • In 4-5% of cases of chronic lower back pain, AS is the cause
  • The prevalence of ankylosing spondylitis is 0.1-1.4% depending on the population 
  • The onset of AS usually occurs in people ages 17-45 but it can also affect people who are younger or older than this. (Median age of onset is 23 years)
  • The male to female ratio of this disease is about 3:1
about ankylosing spondylitis (AS)

  • "Ankylosing Spondylitis." Mayo Clinic. Mayo Foundation for Medical Education and Research, 01 Nov. 2016. Web. 11 Aug. 2017.
  • “Overview of Ankylosing Spondylitis.” Spondylitis Association of America. n.d. Web. 11 Aug. 2017. 
  • “Questions and Answers About Ankylosing Spondylitis.” National Institutes of Health. National   Institute of Arthritis and Musculoskeletal and Skin Diseases, Jun. 2016. Web. 11 Aug. 2017.
  • “What is Ankylosing Spondylitis?” Arthritis Foundation, n.d. Web. 11 Aug. 2017. 
  • “Ankylosing Spondylitis.” Cleveland Clinic. Cleveland Clinic Disease Management, Aug. 2010. Web. 11 Aug. 2017. 
  • “Ankylosing Spondylitis.” Johns Hopkins Medicine. Johns Hopkins Medicine Health Library, n.d. Web. 11 Aug. 2017. 


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