Ankylosing spondylitis: symptoms and treatment

What is ankylosing spondylitis (Bechterew's disease)

Bechterew's disease, or ankylosing spondylitis, is a systemic inflammatory disease of connective tissue with a predominant lesion of the joints and ligaments of the spine.

Peripheral articulations and internal organs may also be involved in the pathological process.

The disease is characterized by a chronic and progressive course, leading to the development of a limitation mobility of the spine and its pronounced deformations, which often becomes the cause of disability of the patient rights.

This pathology was first described in 1892 by V.M. Bekhterev called "stiffness of the spine with curvature". Most young men (sex ratio of 9 to 1) are aged mainly 15-30 years old. If the pathology is found in women, then it is much easier.

Causes

The reasons for the development of ankylosing spondylitis are still unknown. Most researchers believe that the basis of the disease is a genetic defect. This is confirmed by the fact that 90-97% of patients have a histocompatibility antigen like HLA-B27.

But one genetic predisposition for the debut of Bechterew's disease is not enough. For this, the effect of provoking factors is necessary:

• infectious diseases (especial importance is given to urogenital and intestinal infectious lesions);
• hormonal disorders and diseases of the endocrine system;
• hypothermia and other adverse effects of the environment;
• traumatic injuries of the musculoskeletal system;
• acute and chronic stressful situations.

The mechanism of the development of the disease is very complex and not fully understood. The most common hypothesis of the pathogenesis of ankylosing spondylitis is as follows.

When the carrier of a pathological gene falls under the influence of negative environmental factors (especially infectious diseases), the immune system begins to produce antibodies for the control of infectious agents, with the hyperactivation of immunity, that is, more antibodies are produced than required situation.

After all the microbes are destroyed, the antibodies begin to acquire signs of autoaggression, that is, they begin to attack their own body tissues.

In most cases, the place of the primary attack is the sacroiliac joint.

Gradually, the destructive changes of the spine progress, the ossification of all his structures, adjacent vertebrae fuse together, which leads to a limitation of mobility and deformations. Because of osteoporosis of the vertebrae, spinal fractures often occur.

Pathological changes in ankylosing spondylitis

Classification of the disease

Ankylosing spondylitis in ICD-10 (international classification of diseases 10 revision) is under the code M45. Depending on which joints are involved in the pathological process, distinguishes several clinical variants of the disease:

1. The central form - only the spine is affected. In this case, there may be a kyphoid type, when the deformation occurs according to the type of hyperkiphosis of the thoracic spine and cervical hyperlordaza. The second option is the rigid type, when all the physiological curves of the spine disappear, and the spinal column looks like a straight stick.
2. Rizomelicheskaya form - with the defeat of the joints of the spine is combined with the inflammation of the shoulder and hip joints.
3. Peripheral form - along with the damage to the spine, the peripheral joints of the extremities (knee, elbow, ankle, and wrist) are drawn into the pathological process.
4. Scandinavian form - when in parallel with the defeat of the spine small joints of the hands become inflamed.
5. Visceral form - combines one of the above listed forms + any lesions of internal organs.

There are three types of disease:

• stable slowly progressing;
• slowly progressive with periods of exacerbations;
• fast-progressing.

Thus, whichever version of Bekhterev's disease is, in each case there are symptoms of spinal column damage, which can be considered a pathognomonic sign of this disease.

Symptoms

Alas, but no specific symptoms of ankylosing spondylitis.

The onset of the disease is usually invisible, and often it happens that the patient notices any violations already at the height of the pathology or even complications.

Let's consider, on what early signs it is possible to suspect a pathology, and also we will understand, as the disease at the late stage is shown.

Early signs of illness

The onset of pathology is imperceptible. Some patients, several years before the diagnosis, note a constant general weakness, sensation stiffness in the spine, incomprehensible and unintensive pain (unpleasant sensations) in the joints and muscles, losing weight.

Pain in the lumbosacral region - an early sign of ankylosing spondylitis

After this, the patient begins to complain of stiffness in the spine in the mornings, which goes to dinner or even in the evening, pain in affected joints (especially in the second half of the night, which prevents a person from sleeping), this makes you constantly take painkillers preparations.

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A characteristic symptom is pain in the region of the sacrum and buttocks, which leads to frequent and erroneous diagnoses of lumbosacral radiculitis.

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Gradually the inflammation develops in all parts of the spine, as a rule, this period ranges from 2 to 10 years (depending on the type of pathology).

Late symptoms

As the disease progresses, there is pain in the chest, a restriction of her excursion, which leads to a violation of the rhythm and depth of breathing, the pain appears when coughing and sneezing. Patients complain of constant general weakness, low-grade fever, increased fatigue.

Changing posture of the patient, which depends on the form of the disease.

Develops hyperkiphosis of the thoracic and hyperlordias of the cervical spine (the pose of the petitioner) or, conversely, all the curves of the vertebral pillar, and a person can not bend even a few centimeters or turn his head a few degrees (deformation by the type of bamboo sticks). When the peripheral form develops arthritis of large joints, with the Scandinavian - the defeat of the brush by the type of rheumatoid arthritis.

Pose of a petitioner in a patient with Bekhterev's disease

Diagnostics

Unfortunately, there are no specific diagnostic criteria that would allow a 100% diagnosis to be made correctly.

Diagnosis of ankylosing spondylitis is based on the clinical picture and some data additional examinations: radiography, detection of HLA-B27 and laboratory signs inflammation.

Diagnostic criteria for Bechterew's disease:

1. Pain in the sacroiliac region, which disturbs a person from 3 months and does not decrease at rest.
2. Pain and stiffness in the thoracic spine and thorax.
3. Limitation of mobility in the lumbar spine.
4. Inflammation of the iris - irit (acute or transferred in the past).
5. X-ray signs of bilateral inflammation of the sacroiliac joints.

The diagnosis is considered reliable if the last criterion (radiology) is present, as well as one of the other aforementioned or all clinical ones without radiographic confirmation.

Radiography is an obligatory diagnostic method for Bechterew's disease

Principles of treatment

Treatment of ankylosing spondylitis is a very complex and almost unresolved problem. Basic principles of therapy for Bechterew's disease:

• elimination of the factor that caused the development of the disease or its aggravation;
• increasing the body's defenses;
• adequate and timely use of antirheumatic drugs for the elimination of the inflammatory process and prevention of deformity of the spine;
• restoration and preservation of the functions of the spine.

We also recommend reading:Symptoms of Bechterew's disease in women

Treatment of ankylosing spondylitis includes the following measures and medications:

1. Non-steroidal anti-inflammatory drugs (celecoxib, nimesulide, meloxicam, diclofenac, indomethacin, butadione).
2. Sulfanilamide preparations are sulfosalazine.
3. Glucocorticoid hormones - prednisolone, methylprednisolone for systemic and pulse therapy, with peripheral joint damage, intra-articular injections with Diprospan, Kenalog, Metipred are used.
4. Elimination of painful spasm of the muscles of the spine - midogalm, tizalud, sirdalud.
5. Physiotherapeutic treatment (magnetotherapy, UHF, UFO, electrophoresis, laser therapy, ultrasound, paraffin therapy).
6. Physiotherapy.
7. Spa treatment.

To this scheme of treatment sometimes cautiously add cytostatics, if glucocorticoids do not completely eliminate pathological symptoms. Most often prescribed medicines such as azathioprine, cyclophosphamide, chlorbutin.

Making the conclusion, it is necessary to note that the prognosis of the disease is conditionally unfavorable.

All existing methods of treatment only temporarily slow the progression of pathology and improve the quality of life, but sooner or later a disease leads to specific deformations of the spine and the person becomes disabled, and in the case of the defeat of internal organs there is a direct threat to life.

But, despite such a pessimistic forecast, clinical trials of new methods for treating Bechterev's disease, which will cure a person of this ailment, are in full swing now. One of these is stem cell therapy.

A source: http://MoyaSpina.ru/bolezni/chto-takoe-ankiloziruyushchiy-spondiloartrit-bolezn-behtereva

What is ankylosing spondylitis: symptoms and treatment of ankylosing spondylitis spondylitis

Ankylosing spondylitis - this is one of the subspecies of arthritis, which is characterized by inflammation of the joints of the spine in the sacroiliac region.

Progressive rigidity and arthrodesis (limited mobility of the axial skeleton) are related complications.

In medical reference books spondylitis of the lumbar spine is often referred to as Bekhterev's disease.

Let's determine who is at risk.

Unlike most articular diseases, ankylosing spondylitis develops in young enough and active people aged 25 to 40 years.

Men suffer more often than women. On average, the symptoms of the disease are detected in% of the population in most countries.

Until now, it has not been fully established whether an infection can be considered an antigen-provoking ankylosing spondylitis.

Symptoms of spinal fibrillation of the lumbar spine

Bekhterev's disease is characterized by a long course - the initial stage of the disease can last for months and years, pathological changes do not even show X-rays. Recognize the disease at its very beginning can be on such grounds:

• Pain in the lumbar spine, often occurring suddenly;
• Stiffness in the same area of ​​the back, which occurs after prolonged rest or night sleep, and quickly passes during movement.

If you make the x-ray of the lower back and the gluteal region at this stage, you can mistakenly diagnose sciatica according to the visible pattern.

The pain is felt symmetrically, and this is a distinctive feature of spondyloarthritis. Symptoms first of all are noted in the lower back, but with the development of the disease spread ascending and gradually cover all parts of the spine, including the thoracic and cervical spine.

Ankylosing of the spine with the course of the disease progresses, stiffness and secondary osteoporosis develop. At this stage, the X-ray as a diagnostic method is effective.

All this leads to vertebral fractures - the patient experiences strong, prolonged pain.

In rare cases, Bekhterev's disease has another complication, secondary compression of the spinal cord.

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Physiological symptoms, according to which it is possible to recognize Bekhterev's disease at an early stage of development, if it is impossible to make an x-ray for some reason:

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1. When tilted forward, the lumbar flexure of the back (lordosis) does not equalize.
2. If you press your palms in the area of ​​the sacral spine, the patient will feel a sharp pain.
3. The mobility of the spine in the lumbar region is severely limited in any of the directions.

Stiffness in the progression of the disease of the disease covers all parts of the spine and often leads to a restriction of the mobility of the chest. The fusion of the vertebrae can be noted in varying degrees of spread. Symptoms of arthrodesis are as follows:

• Pronounced kyphoid curvatures of the dorsal and cervical spine;
• Merging of these parts of the spine when viewed from the front.

In combination with a violation of the flexural function of the hip and knee joints, arthrodesis leads to a complete loss of the patient's ability to work.

Sacroiliitis is another symptom by which it is possible to diagnose spinal fusion of the spine. Initially, the cortical layer in the joint tissues becomes non-uniform, then the interarticular clefts widen, sclerosis develops and, ultimately, arthrodesis.

If you make a roentgen of the spine in the lateral projection, changes in the shape of the anterior part of the thoracic and lumbar vertebrae will be noticeable. Due to erosion and sclerosis of bone and joint tissues, the vertebrae become rectangular in shape.

The anterior longitudinal ligament is ossified and the articular facet is melted, which also clearly shows the X-ray.

Together, these symptoms lead to the development of the so-called "bamboo spinal column syndrome".

Invertebral symptoms

If treatment has not been started at the developmental stage, Bekhterev's disease extends to the entire musculoskeletal system of man. Depending on which joints are affected in the first place, patients complain of such symptoms:

1. Pain in the sternum, intensifying with deep inspiration, is the result of defeat of the costal-vertebral articulations;
2. Pain in the heel and feet when moving as a manifestation of plantar fasciitis and Achilles tendon tendonitis caused by enthesopathy;
3. -Fast fatiguability.

Lesions of the articular membranes of the extravertebral articulations are noted in 40% of all patients. In 10% of cases, the symptoms of the inflammation of the hip, knee, brachial or ankle joint are detected earlier than Bekhterev's disease is diagnosed.

In 10% of cases of the disease, its first signs are manifested in childhood. Peripheral joints in this case are affected symmetrically, the inflammatory process is diagnosed as an oligosupunctive juvenile idiopathic spondylitis.

Spondyloarthritis of this form is rarely accompanied by involvement of the invertebrate joints in the inflammatory process. Much more often the eyes are affected - often before the diagnosis of Bekhterev's disease.

How is spondyloarthritis diagnosed?

First of all, an X-ray is performed - the images obtained are the main basis for an accurate diagnosis. The difficulty is that sometimes it takes years to detect the first changes in vertebral joints, even with the help of radiography.

That is why, when suspected of spondylitis, x-rays are done repeatedly with a certain periodicity. It is important to do an x-ray not only of the spine, but of other articular joints.

Bechterew's disease - treatment

Treatment is aimed at eliminating pain syndrome, preventing fracture and fusion of the vertebrae, restoring the functionality of the spine and extravertebral joints, if they were affected.

Treatment in the early stages is reduced to adjusting the regimen and lifestyle of the patient. Spondyloarthritis can be stopped by regularly performing special medical exercises for stretching the spine and strengthening the muscular corset around it. Treatment with physiotherapy gives a good effect.

If the control x-ray showed no improvement, a medication is prescribed. NSAIDs of long-term action help to relieve pain and prevent the morning stiffness of the joints. Treatment with folk remedies can act as an additional and preventive at this stage, but not the main one.

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With the help of sulfasalazine, metrotrexate, azathioprine, synovitis of peripheral joints is treated. Treatment with TNF-a inhibitors helps to reduce the symptoms of spondyloarthritis and improve mobility.

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The treatment of plantar fasciitis (X-ray for diagnosis is necessary) is often carried out with the help of local hormonal injections. Oral steroid treatment sometimes gives results when you leave, but is not widely practiced.

If the X-ray showed extensive and serious changes in the joint tissues of the shoulder, knee or hip, resulting in mobility is severely limited, surgical treatment is selected. Complex arthroplasty of peripheral joints in most cases allows to avoid surgery on the spine.

Forecasts for Bechterew's disease

Despite the fact that Bekhterev's disease significantly limits the mobility of the person and the functionality of the joints of the spine, about 75% of patients in to continue working activity and to participate in an active, full-fledged life - if the treatment is carried out qualitatively according to the chosen program.

Even if spondyloarthritis accompanied by ankylosis develops, and the X-ray shows vertical fusion of the vertebrae, it is not necessary that the mobility is as limited as it may seem.

More severe and serious forms of the disease is considered to be hip, knee and shoulder injury joints in the complex, more details about the life expectancy with Bekhterev's disease can be found in our site.

A source: http://sustav.info/bolezni/spondyloarthritis/ankiloziruyushhij-spondiloartrit.html

Spondyloarthritis: what is it, symptoms, treatment

There are many diseases known to date in medicine that contribute to the destruction and deformation of human bones, in particular - the spine.

The vertebral column is one of the main organs in the human body, since it performs the supporting and motor function, contains the spinal cord, and is also a fixation for all internal bodies. Any violation in the spine entails painful consequences.

One of the slowly progressing diseases of the musculoskeletal system is spondyloarthritis. Due to the development of this ailment, a person suffers pain in the back, a restriction of the motor function, a violation of the structure of the joints.

In this article we will consider what it is - spondyloarthritis, how the disease manifests, how dangerous it is and what measures should be taken.

Definition and characterization of the disease

Spondyloarthritis of the spine is a degenerative-inflammatory disease of the ODA, in which the spinal column is destroyed and deformed, causing its curvature.

Pathology develops slowly, gradually acquiring a chronic form.

The spine becomes inactive and brings discomfort to the person during any movement.

Spondyloarthritis in the chronic stage can cause disability due to a strong change in the structure of the body of the vertebrae. The degree of danger is determined by the stages of the development of the disease:

1. The first stage of the disease is characterized by the presence of cracks or cracks in the vertebrae, a slight limitation of motor ability, a barely noticeable curvature.
2. In the second stage, the natural cracks between the joints narrow, which severely restricts the person in movement. Possible loss of ability to work.
3. At the final stage of the disease, the mobility of the spine and joints is reduced to a minimum, or absent altogether. A person loses his ability to work and acquires a disability due to his state of health.

Classification

In modern medicine, there are two types of this disease:ankylosingSpondyloarthritis, also called Bechterew's disease andseronegativespondyloarthritis.

Consider what it is in more detail. Ankylosing and seronegative spondylitis - a variety of one disease, differ in the nature of the development of inflammation.

Ankylosing is characterized by a chronic course with slow progression of joint stiffness and fusion of the vertebrae.

At the same time, the inflammation does not occur in the joint, but in the place of its binding to other bones - in the ligaments and tendons, muscles.

The name ankylosing occurs from the phenomenon of ankylosis - fusion of the vertebrae into fixed structures.

The nature of the disease is similar in clinical manifestations to rheumatoid arthritis, which extends not only to bone tissue, but also connective.

Seronegative spondylitis (spondylitis) is a group of diseases similar in clinical manifestations and pathogenic properties.

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They have a striking inflammatory property on the joints and bones in the area of ​​the vertebral column and the vertebrae themselves.

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With seronegative spondylitis, prolonged or permanent pain in the back, changes in posture, impairment of the supporting and motor function of the spine, difficulty in movement and breathing.

Causes

The causes of the inflammatory disease of the joints and spine of psoriatic character are reduced to a violation functioning of the body's immune system, which perceives the body's own tissues as alien and aggressive affects them.

This phenomenon is explained by a hereditary pathology - the presence of HLA antigen B27, which sends a signal to the brain about the presence an alien body in the human body (in this case - joints or spine), then, the body tries in every possible way to tear away own fabrics.

The consequences can be very deplorable: complete immobilization of the spine due to fusion of the vertebrae, loss of flexibility, reduction the functional volume of the lungs (impossibility of chest expansion during breathing), decreased quality of life and loss ability to work.

Also, among the causes of the onset of spondyloarthritis, the diseases of the genitourinary and digestive system in severe form are revealed.

Symptoms

If the cause of the disease is a genetic predisposition to rejection of the body's own tissues, the clinical picture will be based on the fusion of the vertebrae and joints of the sacro-lumbar, thoracic, intercostal space near the vertebral post.

Attention should be paid to such manifestations as inflammation of tendons, ligaments and joints (knee, hip) for no apparent reason.

In the latter stages, the disease affects the internal organs, causing a violation of their function.

A person can not consult a specialist for a long time with such a problem, considering the physical overstrain caused by such sensations.

In the latter stages, the doctor notes that the patient has the following symptoms:

• defeat of internal organs;
• fusion of vertebrae;
• impairment of respiratory function;
• constant pain in the muscles of the back;
• weakness and weight loss;
• temperature increase;
• other signs of anti-inflammatory reaction of the body.

Treatment

Spondyloarthritis can be cured in the early stages of the disease, and with prolonged course it is possible only to reduce the degree of symptomatology, but to completely restore the functions of the spine it will turn out.

The danger is that the disease can be asymptomatic for a long time, as mentioned above. Therefore, it is not always possible to prevent its consequences.

The aim of the treatment is to restore the spinal locomotor activity, to eliminate the pain syndrome, to prevent further coagulation of ankylosis.

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An integrated approach to the treatment of spondyloarthritis includes medical therapy, physiotherapy, lfq, massage, surgical intervention.

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To eliminate the autoimmune nature of spondylitis, apply:

• preparations of non-steroidal type (orthophene, nimesil, voltaren, etc.);
• antirheumatic drugs for the treatment of joint inflammation;
• corticosteroids are used to reduce inflammation in the last stages of the disease;
• anti-inflammatory drugs;
• muscle relaxants;
• hormonal preparations;
• drugs that improve microcirculation.

Physiotherapeutic methods must necessarily be included in the therapy of spondylitis:

• reflexology;
• treatment by ultrasound and laser;
• magnetic procedures;
• inductometry;
• procedures of plasmosorption, plasmapheresis, phonophoresis.

With a significant restriction in movement due to the adhesion of ankylosis, the patient can be directed to an operation to restore the mobility of the spine. Usually this means prosthetic joints, as well as surgical treatment of inflammation of the spine.

Also, the expert will recommend the patient the correct physical activity to restore the flexibility and motor activity of the spine.

LFK and massage with spondylitis

Therapeutic physical activity is necessary in the treatment of diseases of the musculoskeletal system in order to eliminate such problems as:

For a patient with a diagnosis of spondylitis, swimming, gymnastics for the back on the rug, joint exercises are prescribed.

Back massage, prescribed as an additional measure of treatment, should be performed only by qualified specialists to avoid injury to the joints and vertebrae.

Massage is necessary to restore joint mobility, tone and strengthen muscles, relieve pain syndrome.

Prevention

To prevent the dire consequences of spondyloarthritis, patients are advised to follow the rules healthy sleep: a solid surface for sleep, no pillow, indoor temperature 16 degrees Celsius, duration 6-9 hours.

In everyday life it is important to adhere to a healthy lifestyle: active rest, exercise, proper nutrition, including all the necessary micro- and macronutrients, proper posture.

Attention! The main risk factor for developing the ailment of the musculoskeletal system is overweight. Avoid weight gain.

Sanatorium treatment is recommended as a prophylaxis for patients who are predisposed to spondyloarthritis or the initial stage of the disease. Prevention includes treatment of mud, hydrogen sulfide and radon baths.

A source: http://vsetelo.com/bolezni/zabolevaniya-oda/artrit/spondiloartrit.html

Ankylosing spondylitis or Bechterew's disease - causes, diagnosis and classification with a photo

A disease more often affecting young men (ankylosing spondylitis or ankylosing spondylitis) was first described by neurologist Bekhterev in 1893

, but the reasons for its development to date have not been finally determined.

The disease is considered incurable, but with proper and timely treatment, it is possible to avoid the most severe form.

What is ankylosing spondylitis?

Bechterew syndrome is a chronic systemic disease that belongs to the group of rheumatoid arthritis. In the International Classification of Diseases of this pathology, the code M45 is assigned.

A feature of the ankylosing form of arthritis is the occurrence of an inflammatory process outside the joint and the gradual immobilization, ossification of the ligaments.

The concept of spondylosis is based on the definition of the disease as a predominantly axial (vector) lesion of the spine.

Spondyloarthritis occurs in men 7 times more often than in women, with the average age of a patient with such a diagnosis of 24 years.

The result of the progression of the disease is a complete loss of flexibility and mobility of the spine.

The first signs of spondyloarthritis are difficult to notice because of the mild pain and instability of their manifestations.

The absence of obvious symptoms in the early stages of the disease leads to the progression of the disease and complications.

The main sign of Bekhterov's disease common to men and women is Kushelevsky's symptom:

• soreness in the lumbar region with pressure on the lower back;
• the occurrence of pain in the lower back when being laid down on the back of one leg down and simultaneously pressing on the iliac bone of the other leg.

Clinical manifestations of ankylosing spondylitis in women are manifested by pain in the lumbosacral section spine, which in the early stages arises periodically and disappears by itself after some time. Other symptoms of Bechterew's disease in women include:

• the appearance of swelling of the peripheral joints;
• feeling of stiffness in the neck in the morning;
• deterioration of vision;
• pain occurs in the bones and joints.

In men

Symptoms of inflammation in men are more pronounced than in women, but the self-transient nature of the pain syndrome often becomes the reason for postponing treatment to the hospital.

Ignoring the early symptoms of spondyloarthritis leads to a marked deformation of the posture of the patient.

The characteristic signs of ankylosing arthritis in men are the following:

• the appearance of painful sensations that are localized in the lumbar region;
• increased pain in the absence of motor activity and its disappearance during physical exertion;
• soreness is accompanied by a feeling of stiffness;
• the appearance of shrouded myositis-like pain.

X-ray signs

If there is a suspicion of spondyloarthritis, a radiographic examination of the patient is carried out, for this purpose the doctor prescribes the performance of X-rays of the ileosacral articulation and spine. The most obvious symptoms of the presence of Bechterew's disease are:

• blurred edges of the joint-forming bones;
• erosion of articular surfaces;
• formation of syndesmophytes (bone bridges);
• blurring of the articular plates.

Causes

The etiology of the inflammatory disease remains unclear.

As a result of clinical observations, the links between the occurrence of ankylosing chronic arthritis and the carrier of Klebsiella (opportunistic bacteria) have been revealed.

Important is the genetic factor, which determines the predisposition to pathological changes in the spine.

Spondyloarthritis is considered a disease of idiopathic nature (primary, unknown etiology), but there are a number of scientific assumptions that this pathology can be a consequence of alcohol abuse, chronic infections, trauma, hormonal violations.A possible cause of the development of ankylosing arthritis is the carrier of the antigen, which is a catalyst for pathological changes in immune cells.

Classification of the disease

The area of ​​the onset of chronic inflammatory disease is the determining factor in the classification of ankylosing spondylosis:

Form of the disease	Area of ​​injury	Clinical manifestations of the disease
Central	Vertebral column	There are two varieties of this form of the disease: kyphoid and rigid. With the first variety kyphosis of the thoracic region develops, with the second - there is a complete fusion of the lumbar vertebrae
Risolimic	Spine, shoulder and hip joints	Pathological changes occur in the root joints
Peripheral	Spine, elbow, knee, ankle joints	The peripheral form of the disease is characterized by the presence of signs inherent in the central form, peripheral joint lesions are observed (symptoms, as in peripheral arthritis)
Scandinavian	Carpal joints	No deformation changes, pain and swelling around the small joints of the hand
Visceral	Vertebral column, joints, internal organs	Against the backdrop of the spine, pathological changes occur in the internal organs (damage to the kidneys, retina of the eyes, heart)

Diagnostics

The doctor makes a conclusion about the presence of ankylosing spondylitis on the basis of examination of the patient, studying the history of his illness. The final diagnosis is established after receiving the results of the complete complex of studies. Diagnosis of Bechterew's disease includes:

• Makarov's tests;
• X-ray examination;
• the delivery of blood tests for the determination of ESR indicators (erythrocyte sedimentation rate);
• computed tomography;
• magnetic resonance imaging;
• molecular-genetic research (if necessary to ascertain carrier of the antigen).

Treatment of Bechterew's disease

Therapy of ankylosing spondylitis is aimed at the elimination of severe manifestations of the disease, and the main task is to control the pain during periods of spondylitis.

Specific treatment for Bechterew's disease is absent, non-steroid medicines are used anti-inflammatory drugs (NSAIDs), glucocorticoids, immunosuppressants, blockers of the necrosis factor tumor.

Along with drugs in the complex treatment of the disease includes physiotherapy, therapeutic gymnastics, diet.

Preparations

To stop inflammation in spondyloarthritis NSAIDs are used (Diclofenac, Indomethacin), with high activity diseases - glucocorticoids (Methylprednisolone), in the absence of a positive effect of treatment - immunosuppressants (Azathioprine, Cyclophosphamide):

• name: Indomethacin;
• description: has a strong inhibitory effect, has a high analgesic activity;
• pluses: high efficiency;
• cons: the presence of side effects and contraindications.

Preparations of the new generation have a directional effect on the cause of spondylitis and neutralize the inflammatory mediators, thus reducing the chain inflammatory reaction:

• name: Infliximab;
• description: biological immunosuppressant, forms stable links with pathogenic cells, reducing their activity;
• pluses: quick action;
• cons: the risk of developing allergies.

Physiotherapy

An additional measure during exacerbation of spondylitis is physiotherapy. The most effective methods of physiotherapeutic treatment of ankylosing arthritis are:

• electrophoresis with the use of anti-inflammatory drugs;
• naphthalan therapy;
• mud treatment;
• ultrasound with hydrocortisone;
• magnetolaser therapy;
• radon baths.

Prevention

In Bekhterev's disease, motor activity is of great importance, the purpose of which is to preserve the mobility of all parts of the spine. To prevent complications and normalize the quality of life of patients, it is necessary to follow the recommendations:

• perform a set of physical exercises;
• avoid high loads on the spine;
• maintain proper posture;
• consume more protein products;
• undergo a course of massage.

Photo of Bekhterev's disease

A source: http://sovets.net/15305-ankiloziruyucshij-spondiloartrit.html

How dangerous is ankylosing spondylitis and what forms does it have?

Ankylosing spondylitis, better known as Bechterew's disease, is a chronic disease of the joints of the spine. Its main characteristic is a complex inflammatory process, which is difficult to treat and limits the functionality of a person.

What is in μb 10 and what are the reasons

Ankylosing spondylitis (code on microbial 10 - M45) was first described by the Russian doctor neuropathologist Vladimir Bekhterev (hence the second name of the disease).

At the initial stage, the lesion occurs in the sacral or pelvic region of the spine. There is stiffness, acute pain, local hyperthermia, human activity decreases. In the course of the development of the disease, inflammation increases.

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Can ankylosing pelvic, shoulder, ankle, knee, intercostal, intervertebral joints.

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To this ailment various disorders are added: osteoarthritis, myocarditis, anemia, arrhythmia, inflammatory processes of the kidneys, arthritis, eye diseases.

The International Classification of Diseases 10 revision (ICD-10) characterizes ankylosing spondylitis as disease of the musculoskeletal system and connective tissues, which is part of the group of dorsopathies, class spondylopathy. According to the ICD 10, this ailment is identified by the code M45.

So far, no true cause of development has been identified. Some scientists agree that the pathogenesis of this condition is the specific HLA-B27 antigen.

Therefore, the disease is considered to be autoimmune. It was found that only 85% of patients with axial spondylitis have this antigen. This raises some doubts.

Ankylosing spondylitis or spondylitis can complicate life, immobilize a person, turning the spine into a bone monolith. In severe lesions, inflammation can touch the internal organs, causing myocarditis, osteomyelitis.

Symptoms and Diagnosis

At the initial stage of the disease, a person begins to notice the discomfort in the lumbar region.

Moderate pains, a feeling of stiffness, especially in the morning or in the evening, may appear.

With the development of ailment, there may be pain in the neck, thoracic region. It becomes hard to breathe fully.

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The mobility of the spine is reduced in several stages. At the same time, the skeleton is shortened. The spine deforms into an arcuate shape, the upper and lower limbs remain bent at the elbows, knees. The patient's body acquires the so-called "petitioner" pose.

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A diagnostic study for the presence of idiopathic ankylosing spondylitis begins in the doctor's office. After a physical examination, the patient is assigned a hardware diagnosis, a series of clinical studies to establish the correct diagnosis.

The patient underwent X-ray examination. On the X-ray images there will be obvious changes in the steric structure. For additional information, the use of computer and magnetic resonance imaging is important. A blood test will provide information about the presence of an inflammatory process.

To determine the disease, differential diagnosis is necessary.

Spondyloarthrosis has similar signs, but the approach to treatment is different. Rheumatoid arthritis should also be excluded.

Forms and types of disease

Depending on the degree of lesion, localization of the focus of the inflammatory process, five main forms of Bechterew's disease are distinguished:

1. The central form of spondylitis. In this case, the damage occurs in the spine of a person. With the development of the disease symptoms increase. There may be asphyxia attacks, muscle cramps, hypertension.
2. Risomelic form is characterized by lesions of the spine and large joints (mainly shoulder, hip, pelvic). The disease is also slowly developing. Painful sensations in the lower back are given to the gluteal or inguinal zone. Discomfort of extremities can be observed.
3. In the peripheral form of the disease, the region of the sacroiliac joints is the first to suffer. After a certain time, the joint structure of the feet and knees is attacked. More often this form of the disease is found in adolescents and young people, rather than in adults.
4. The Scandinavian form is characterized by the same features as for the peripheral, with one difference - the smaller joints (similarity to rheumatoid arthritis) suffer more. Destruction appears in the hands, feet. This form is not characterized by the presence of severe pain symptoms.
5. The visceral form can mean one of the above forms with the addition of lesions of the internal organs.

In addition to deforming spondylitis, cervical and lumbar are distinguished.

The first affects the upper part of the spine, the damage is to the cervical vertebrae and clavicles.

Due to muscle atrophy, immobility of the upper limbs is observed. The second - characterizes the involvement of the lumbar spine.

Types of treatment

Treatment of ankylosing spondylitis is long and time-consuming. It lasts until the onset of remission. Most often this is a complex of measures, the main part of which is carried out under the conditions of a hospital.

1. The use of non-steroidal anti-inflammatory drugs is necessary to eliminate the inflammatory process (Diclofenac, Ketoprom, Ibalgin). The drugs block the production of prostaglandins, which are responsible for the occurrence of inflammation. Long-term use of such drugs causes discomfort of the digestive tract.
2. Use of glucocorticoids or steroids. If you get into the body of hormonal substances, the immune system is suppressed. Due to this, the process of inflammation stops. Taking such medications has many contraindications and a wide list of side effects. The duration of treatment should be limited.
3. In particularly severe disease, immunosuppressive agents are used. These drugs weaken the immune system, prevent further self-destruction of the body. To treat this disease, one of the following drugs is prescribed: Methotrexate, Cyclosporine, Azathioprine, Ridaur, Penicillamine, Solganal or Sulfasalazine.
4. Physiotherapeutic procedures include therapeutic massages, vacuum therapy, warming up.
5. Manual therapy is also used in the complex treatment of spondylosis. This includes reflexology, acupuncture, acupressure.
6. Complex exercise therapy is an important component of the treatment of this kind of diseases. Physiotherapy exercises can delay the process of destruction, expand the breadth of movements, eliminate pain.

Some people resort to the help of traditional medicine. It is important to understand that the practice of spondylitis treatment at home is unjustified and carries many threats concerning human health.

The surgical method of treatment is rarely used due to the complexity of his vision. The stimulus for surgery can be the young age of the patient and the lack of response to medication.

Proper nutrition and diet

Proper nutrition is a necessary measure if ankylosing spondylitis, spondyloarthritis or spondyloarthrosis progresses.

The main task of the diet is the enrichment of the body with useful substances.

During the use of medications from the tissues, a large part of the important trace elements is washed out, the stock of which must be replenished.

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The second important task of special nutrition is weight reduction. Excess kilograms create unnecessary strain on the spine. During treatment with ankylosis patient should formulate a new menu, reduce the daily rate of kilocalories to 1000 units.

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There are some recommendations on nutrition that must be followed in the treatment of spondylitis:

• from the diet should be removed salt, fast carbohydrates and dairy products;
• meat should be dietary and cook for a couple;
• avoid or reduce the consumption of products with starch content;
• to eliminate from use fast food;
• give preference to vitamin drinks (juices, fruit drinks, compotes);
• sour-milk products should with a minimum percentage of fat content.

Observance of all nutrition conditions will help regulate metabolic processes in the body, improve the work of the gastrointestinal tract, eliminate excess body weight.

Prevention

To prevent the development of ankylosing spondylitis, a person should organize the right way of life.

It is necessary to lead an active lifestyle, but physical activity should be moderate, alternating with a full rest.

Regular nutrition is also a necessary measure for the prevention of Bechterew's disease. It is necessary to avoid situations that threaten hypothermia and spinal injuries.

Bechterew's diseaseDiagnostics of the contralateral side of what happens

A source: http://PozvonochnikPro.ru/bolezni-sustavov/ankilozirujushhij-spondilit.html