Ankylosing spondylitis

Ankylosing spondylitis
Other names	Bekhterev's disease, Bechterew's disease, morbus Bechterew, Bekhterev–Strümpell–Marie disease, Marie's disease, Marie–Strümpell arthritis, Pierre–Marie's disease[1]
A 6th-century skeleton showing fused vertebrae, a sign of severe ankylosing spondylitis
Specialty	Rheumatology
Symptoms	Back pain, joint stiffness[2]
Complications	Eye inflammation (uveitis), Compression fractures, Heart problems.[3]
Usual onset	Young adulthood[2]
Duration	Lifetime[2]
Causes	Unknown[2]
Diagnostic method	Symptoms, medical imaging and blood tests[2]
Treatment	Medication, physical therapy
Medication	NSAIDs, steroids, DMARDs,[2] TNF Inhibitor
Frequency	0.1 to 0.8%[4]

Ankylosing spondylitis (AS) is a type of arthritis characterized by long-term inflammation of the joints of the spine, typically where the spine joins the pelvis.^[2] With AS, eye and bowel problems—as well as back pain—may occur.^[2] Joint mobility in the affected areas sometimes worsens over time.^[2][5] Ankylosing spondylitis is believed to involve a combination of genetic and environmental factors.^[2] More than 90% of people affected in the UK have a specific human leukocyte antigen known as the HLA-B27 antigen.^[6] The underlying mechanism is believed to be autoimmune or autoinflammatory.^[7] Diagnosis is based on symptoms with support from medical imaging and blood tests.^[2] AS is a type of seronegative spondyloarthropathy, meaning that tests show no presence of rheumatoid factor (RF) antibodies.^[2]

There is no cure for AS. Treatments may include medication, physical therapy, and surgery. Medication therapy focuses on relieving the pain and other symptoms of AS, as well as stopping disease progression by counteracting long-term inflammatory processes. Commonly used medications include NSAIDs, TNF inhibitors, IL-17 antagonists, and DMARDs. Glucocorticoid injections are often used for acute and localized flare-ups.^[8]

About 0.1% to 0.8% of the population are affected, with onset typically occurring in young adults.^[4][2] While men and women are equally affected with AS, women are more likely to experience inflammation rather than fusion.^[9]