Ankylosing Spondylitis (AS) is an easily ignored disease which often happens to people at their 20s to 40s with male to female ratio of 5 to 1; and the estimated prevalence takes up to 0.2% of the total population in Taiwan.
Characteristics of AS
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Backache and back soreness with stiffness
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More prominent when waking up in the morning
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Limited spinal moving range
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Alleviated symptoms after exercises
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Prevalent around young males aged from their 20s to 40s
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Genetically inheritable
Note:
Besides the spondylitis, it also must pay attention to the peripheral arthritis (eg. knee or ankle arthritis), uveitis (eye red or swelling or photophobia) or enthesitis (eg. heel swelling pain).
Diagnosis:
Ankylosing Spondylitis can be diagnosed of through detailed medical history inquiry, physical examination, radiography, and HLA-B27 gene. 90% patients are HLA-B27 gene positive.
Treatment:
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Education:
It is fundamental to collaborate with your physician for follow-up checks and treatment course because such a disease is usually chronic and repetitive. Therefore, it is suggested that patients should lie flat either on their back with low pillow and firm mattress.
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Heredity consultation:
Of all HLA-B27 positive patients, there are 2% to 10% patients who would eventually suffer from Ankylosing Spondylitis; and if a father is a patient of AS, his child of getting AS is approximately 20%.
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Exercise and physical treatment:
To AS patients, exercise is vital and helpful in reducing painfulness, maintaining spinal moving range, and promoting life quality. There is no restriction over the types of exercise as long as it helps with joint movements. Exercises like soft gymnastics, swimming, jogging, and dances are good choices. Patients should avoid cycling and violent sports like boxing. Maintain correct posture and try not to stay at the same posture like being a couch potato for a long time. Stretch your body and vertebra to prevent spinal deformation.
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Medical treatment
a. NSAID (non-steroid anti-inflammatory drug)
Doctors use NSAID to relieve patients’ discomfort and enable them to work out more and improve their life quality.
b. Immune modulation drug
Salazopyrine is commonly used because it is equipped with the function of regulating immune system. Take two tablets, with 500 milligrams each, after breakfast and supper.
c. Biologic agents
Etanercept, Adalimumab or Golimumab are used in moderate or severe Ankylosing Spondylitis
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Surgery
Surgery is used to improve joint function of patients with severe spinal deformity.
Disease course and prognosis
AS course is usually chronic and repetitive; since the prognosis of AS is quite good, it does not affect patients’ life span; 90% patients in a way still possess good life quality.
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