Focus on ankylosing spondylitis, starting with "early detection" on World Spine Day

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Recently, ankylosing spondylitis was suddenly hung up on the "hot search", because Li Yuchun revealed in a show that he had ankylosing spondylitis
.
After preliminary investigation, the prevalence of ankylosing spondylitis in China is not high, about 0.
3%¹, but considering the population base in China, the patient group is actually huge
.
World Spine Day, celebrated every year on 16 October, is a day to get to know the disease, its manifestations, diagnosis and treatment
.

Ankylosing spondylitis tends to occur in young adults

Ankylosing spondylitis is a chronic inflammatory disease that mainly affects the sacroiliac joint, spine, paraspinal soft tissues and peripheral joints, and severe cases can cause spinal deformity and rigidity, and the late stage of spinal involvement may cause "bamboo-like changes" due to bone hyperplasia.

The disease is more likely to occur in young people, the age of onset is 15~40 years old, 10%~20% of patients develop before the age of 16, the peak age of onset is 18~35 years old, and the onset of patients over 50 years old and under 8 years old is ^rare1
.

Ankylosing spondylitis is genetically related

The cause of ankylosing spondylitis is unknown, but genetic and environmental factors are thought to play an important role in the onset ^{of the disease1}
.
Ankylosing spondylitis has been shown to have a clear familial tendency to aggregate and is strongly associated with
positive human leukocyte antigen (HLA)-B27 gene.
Patients who are HLA-B27 positive should be highly concerned about the possibility of inheriting the disorder in their ^children2
.
However, it should be noted that although ankylosing spondylitis is genetically related, the combination of intrinsic susceptibility genes and external factors (environmental factors, etc.
) in the pathogenic process will cause the disease
.

Understand the manifestations of ankylosing spondylitis and strive for early detection

Ankylosing spondylitis has an insidious onset, and patients generally gradually develop low back or sacroiliac pain and/or stiffness, may wake up in the middle of the night, difficulty turning over, and lower back stiffness is obvious when rising in the morning or standing up after sitting for a long time, but it decreases
after activity.
Some patients have dull hip pain or severe lumbosacral pain that occasionally radiates
to the periphery.
The pain can worsen
when coughing, sneezing, and suddenly twisting the lower back.
Early hip pain is intermittent on one side or alternating between left and right
.
Most patients develop from the lumbar spine to the thoracic and cervical vertebrae, with pain, limited mobility, or spinal ^deformities1
.

Low back pain is an extremely common symptom in the general population, but most are mechanical back pain (herniated discs, lumbar muscle strain), while ankylosing spondylitis is an inflammatory back ^pain1
.
This is also the most dominant and characteristic clinical manifestation of ankylosing spondylitis, and is an important clue for early ^diagnosis3
.
The diagnostic criteria for inflammatory low back pain are: (1) age of onset< 40 years old; Chronic low back pain lasting more than 3 months; (3) Hidden onset; (4) morning stiffness; (5) Improve after activity, not relieve after rest; (6) Night pain<b14>.
In addition, radiological sacroiliitis remains essential for diagnosis, so early imaging is key
to early diagnosis of ankylosing spondylitis.

Ankylosing spondylitis requires comprehensive treatment

The treatment of ankylosing spondylitis includes a combination of non-drug and drug treatment, which, if diagnosed and treated appropriately, can control symptoms and improve prognosis
.
However, there is currently no cure for the ^disease1
.

Non-pharmacological treatments