Ankylosing Spondylitis.
Last updated Friday, February 11, 2005
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SymptomsAnatomy
Ankylosing spondylitis is a systemic disease, meaning it can affect the
entire body in some people. It can cause fever, loss of appetite, and fatigue, and it can damage other organs besides the joints, such as the lungs, heart, and eyes. Most often though, only the low back is involved.
The eye is the most common organ affected by ankylosing spondylitis.
Eye inflammation (iritis) occurs from time to time in one-fourth of
people with ankylosing spondylitis. Iritis results in a red, painful
eye that also leads to photophobia, increased pain when looking at a
bright light. It is a potentially serious condition requiring medical
attention by an ophthalmologist. Luckily, it rarely causes blindness
but it can affect vision while the inflammation is present.
Less frequently, ankylosing spondylitis may be associated with a scaly skin condition called psoriasis.
In rare cases, typically when the ankylosing spondylitis has been
present for many years, ankylosing spondylitis may cause problems with
the heart or lungs. It can affect the large vessel called the aorta
that moves blood from the heart into the body. Ankylosing spondylitis
can cause inflammation where the heart and aorta connect leading to
possible enlargement of the aorta.
Symptoms similar to that seen in ankylosing spondylitis may also may occur along with such conditions as psoriasis, inflammatory bowel disease, or Reiter's syndrome.
It is thought that bowel inflammation is somehow tied to the
development of ankylosing spondylitis and this is the reason that
people with inflammatory bowel disease, i.e. Crohn's disease or
ulcerative colitis are at an increased risk of the illness.
Symptoms The inflammation in ankylosing spondylitis usually starts around the
sacroiliac joints, areas where the lower spine is joined to the pelvis.
The pain associated with ankylosing spondylitis is worse during periods
of rest or inactivity. People with ankylosing spondylitis often awaken
in the middle of the night with back pain. Typically, symptoms lessen with movement and exercise.Progression Over a period of time, pain and stiffness may progress into the upper
spine and even into the chest and neck. Ultimately, the inflammation
can cause the sacroiliac and vertebral bones to fuse or grow together.
When this occurs, the normal flexibility of the spine, including the
neck, is lost and the whole spine becomes rigid. Similarly, the bones
in the chest may fuse, causing a loss of normal chest expansion when
breathing. The hips, shoulders, knees, or ankles also may become
inflamed and painful and eventually lose their mobility. if these joints are damaged to the point where daily activities become compromised or very painful, it is often possible to surgically reconstruct those joints with total hip arthroplasty, total knee arthroplasty, or total shoulder arthroplasty. The heels may
become affected, making it uncomfortable to stand or walk on hard
surfaces.
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