Ankylosing spondylitis (Bechterew’s disease)
disease joint and sciatic apparatus, characterized by inflammation of the pillar of the spine and sacroiliac joints. First this medical phenomenon described by Vladimir Bekhterev, neurologist, after whom the disease has received a second well-known name. The beginning of ankylosing spondylitis manifests these conditions pain in the sacrum, reducing the mobility of the spine as a result – there is stiffness and pain when driving (especially in the morning). Ignoring symptoms, delaying the inflammatory process, resulting in the spine can become almost motionless.
Ankylosing spondylitis is also known as Ankylosaurus spondylitis is a process of systematic destruction of the joints, which is chronic and inflammatory in nature. In this disease is the reduced mobility of the joint by reason of the filling of the cavity of the joint by fibrous tissue. During the progress of the disease is formed by a syndesmosis in which the bones are connected without interruption by connective tissue. Also, there is ossification of the ligaments between the vertebrae.
The incidence of ankylosing spondylitis does not exceed the rate of 2%. Most often the disease develops in males aged 15 to 30 years. Ankylosing spondylitis in women is much rarer.
The main ground for the development of this disease is heredity, and it is the presence of the gene HLA-B27. The immune system in patients with this gene produces abnormal antibodies against their own body tissues.
The main symptoms of spondylitis are that a characteristic of the symptomatic picture of the disease is the gradual manifestation of symptoms with a tendency to increase. The development of the disease is indicated by pain, localized in the sacrum. The pain is invisible nature. In some cases of pain tend to capture the type of peripheral joints. In the second half of the night manifest pain dull protracted.
The early stage of disease development patients with ankylosing spondylitis are experiencing stiffness in the spine. This sensation mostly occurs in the morning. During the inspection it becomes evident reduced respiratory amplitude. Also, there is a weakly developed kyphosis. Originally defined the inflammatory process in the region powszechna-sacral joint, accompanied by pain in the buttocks that can radiate into the thigh.
The following manifestation of the disease is the reduction of the mobility of the lumbar spine. Also at this stage disappears lumbar lordosis of physiological origin. If the affected is the thoracic spine, pain occurs in the back, sending the intercostal nerves. Observed clinical picture, characteristic of neuralgia.
The next stage of development, ankilosiral spondylitis (Bechterew’s disease) is characterized by the development of kyphosis of the thoracic type, in which obezdwijivanie joints, it is localized in rib-vertebral region. Reduced movement of the chest that leads to breathing through contractions of the diaphragm. In the case of lesions of the neck, this part of the body gets stiff, get headaches with character attacks manifests itself dizziness, nausea, sciatica, cervical.
Experts share ankylosing spondylitis in four main forms
- Central form the defeat exposed the spine. The symptoms develop slowly, diagnosis can be established after a few years. Painful sensations arise in night time or when making movements. Initially, the pain localized in the sacral division, moving up the spine.
- rhizomelic Bechterew’s disease is also characterized by a slow buildup of the symptomatic picture. The defeat exposed the hip joints, shoulder joints, spine. The pain appears in the region of the hip joints, gradually moving in the groin, thigh or knee joint.
- the development of peripheral forms of the disease affects feet, knee joints and spine. Primarily affects the joint in the sacroiliac powszechnej area, then defeat captures the peripheral type joints.
- the Scandinavian form of the disease is considered a special manifestation of peripheral type ankylosing spondylitis. The disease is characterized by manifestations of rheumatoid arthritis of the small joints in areas of the hands and feet. The disease in this form has a long latent period in some cases, the disease may not be diagnosed for up to ten years. The distinctive features of long-term remission, no manifestations of athralgia, inflammatory processes in the field pouzdano-sacral joint.
Quite often, Bechterew’s disease affects the organs and systems that have no direct connection with the spine. For example, the beginning of the disease can occur with the symptomatic picture of iritis or iridocyclitis and, in some cases symptoms of secondary glaucoma.
The effects of ankylosing spondylitis affecting the cardiovascular system, manifested by myocarditis and articul damaging the valves of the aorta. In addition, ankylosing spondylitis can lead to the development of renal failure.
Diagnosis of ankylosing spondylitis includes the following measures
- counselling services psychologists and rheumatologists
- a blood test that helps to determine the presence of the factor of heredity, availability and the level of reactive proteins and protein fractions
- radiography of the pelvic area
- magnetic resonance imaging
Correction of ankylosing spondylitis, i.e. the treatment involves the use of drugs that have anti-inflammatory action. Also apply massage, drugs that suppress the immune system of the patient. In some cases we recommend the use of a special diet that is enriched with vitamins and trace elements. The recommendation of treatment professionals Behterevoj disease also include the use of physical therapy with specific exercises, the use of drugs of steroid and non-steroidal nature, treatment of the health resort character.
In the case of low effectiveness of conservative treatment measures, doctors may resort to surgery. However, for the surgery disease needs to evolve to its last stage.