Low back pain is full of charming eyes, how to recognize the real "rigidity"?

With the development of the Internet industry, more and more long-term work is required, and the change of this work mode has led to many long-term cases of young people with cervical and lumbar strain, among which the proportion of low back pain is the highest, according to incomplete statistics, 25~30 years old, one out of every eight people has had symptoms of back pain
.

The low back pain we refer to in life generally refers to the pain located between the edge of the lower rib cage and the buttock scar, usually accompanied by radiating pain
in one or both lower extremities.
Low back pain is actually just a symptom, not a disease, it may be caused by a variety of known or unknown tissue abnormalities or diseases, among which there is a type of low back pain, which is closely related to our rheumatism, that is, low back pain
caused by ankylosing spondylitis.

Low back pain is the most dominant manifestation of ankylosing spondylitis and an early feature
.
Ankylosing spondylitis is a common rheumatology disease
.
With the improvement of the current level of diagnosis and treatment of rheumatism, the popularization of popular science knowledge, and the diseases of some stars, ankylosing spondylitis is more and more known by everyone
.
Then face such a common and varied low back pain
.
How can you peel back the cocoon and remove the fake to determine whether it is ankylosing spondylitis?

First, inflammation is at the heart of many rheumatism, and the same is true
for ankylosing spondylitis.

First of all, we have to judge whether the low back pain is inflammatory low back pain
.
In recent years, the International Expert Working Group on Ankylosing Spondylitis (ASAS) has revised the criteria for inflammatory low back pain, and they believe that low back pain lasting more than 3 months can be considered as inflammatory low back pain if 4 of the following 5 items are met:

The opposite of inflammatory low back pain is mechanical low back pain, which is mainly manifested as worsening after activity and relieved
after rest.
It is more common in lumbar muscle strain, intervertebral disc herniation and other diseases
.

Second, pay attention to the accompanying symptoms, treatment response, family history, and gender
of low back pain.

The main clinical manifestations of ankylosing spondylitis are low back pain, and many times there are accompanying symptoms, such as urethritis, diarrhea, iritis, or tendon enthesitis, especially heel pain
.
These suggest the possibility of ankylosing spondylitis
.

At the same time, ankylosing spondylitis as an inflammatory disease
.
It responds well
to nonsteroidal anti-inflammatory analgesics.
This is also characteristic of
ankylosing spondylitis.
Genetic factors are important factors
in the pathogenesis of ankylosing spondylitis.
Relevant studies have shown that if someone in a parent or sibling has the disease, the prevalence is several times higher than that of normal people
.
Another characteristic of ankylosing spondylitis is a preference for young men
.
Therefore, in clinical encounters with low back pain in young men, attention needs to be paid to screening for ankylosing spondylitis
.

Third, we need to rationally use examination methods to help us diagnose ankylosing spondylitis
.

It is well known that HLA-B27 is associated with the pathogenesis of ankylosing spondylitis
.
However, a positive HLA-B27 does not necessarily mean that ankylosing spondylitis is present, and a negative does not mean that it is not present
.
HLA-B27 is an important reference indicator
.
It is not the "gold standard"
for diagnosis.
In contrast, sacroiliitis is much more diagnostic of ankylosing spondylitis
.
Methods of evaluation for sacroiliitis include x-ray, CT, and MR.

X-ray is the most classic method of diagnosing sacroiliitis, and the most widely used New York standard is also based on X-ray as a grading standard
.
However, the sensitivity of sacroiliitis detected on x-rays is poor
.
In contrast, MR can detect earlier sacroiliitis, but MR-diagnosed sacroiliitis needs to exclude special conditions
such as infection, tumor, fracture, postpartum, and strenuous exercise.
Compared with MR, CT is less sensitive than MR, but it can show bone changes
more clearly.
Compared with MR, the cost is lower and the time is short
.
It has good diagnostic value
.
In general, magnetic resonance is preferred for short onset and CT or x-ray
may be considered for a long time.

Although at present our understanding of ankylosing spondylitis is becoming
clearer.
However, plausible "ankylosing spondylitis"
is often encountered in clinical practice.
The real causes are lumbar tuberculosis, bone infiltration of leukemia, tumor bone metastasis, fibromyalgia syndrome and so on
.
Especially in ankylosing spondylitis
diagnosed at an early stage.
Be sure to watch the development of the disease
dynamically.
Timely assessment
.
Avoid misdiagnosis
.