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Seven Signs of Ankylosing Spondylitis

Ankylosing Spondylitis -7 Signs You Should Know About

Did you know that ankylosing spondylitis is a condition frequently missed or misdiagnosed? Unfortunately, many young patients that develop ankylosing spondylitis get diagnosed late. Why? Most patients think their back pain is the results of an injury or previous sports accidents. However, it is very important to recognize the most frequent signs and symptoms of ankylosing spondylitis and get to a rheumatologist soon after these symptoms develop.

In this article, I will discuss:

What Is Ankylosing Spondylitis?

Who Develops Ankylosing Spondylitis?

What Are The Most Common Seven Signs of Ankylosing Spondylitis?

What is Ankylosing Spondylitis?

Ankylosing spondylitis, or AS, is an inflammatory disease. It often affects the spine, the peripheral joints, and the tendons but may also affect other organs as well, such as the eyes, heart, or kidneys. It is most commonly associated with the gradual fusion of vertebrae in the spine, which occurs gradually over time. This disease leads to a reduction in spine flexibility and, gradually, the development of a hunched posture.

Who Develops Ankylosing Spondylitis?

Most patients that develop AS are young, most of them under the age of 45. Their symptoms start gradually over the course of weeks or months.  Some patients are diagnosed late, after the age of 50, and specific signs on their X-rays or MRI can suggest that this disease was present for many years.

What Are The Most Common Seven Signs of Ankylosing Spondylitis?

There are seven common signs or symptoms seen in patients with AS. In this video, I am explaining the most common seven signs of ankylosing spondylitis.

  1. Back Pain: Pain in the lower back, sacroiliac joints (joints in the pelvis or lower back), and neck are the most common symptoms in patients with AS. Patients will especially experience back pain in the morning, accompanied by stiffness that will last more than 1 hour. The pain worsens with rest, so the best pain-reliever is exercise. If left untreated, inflammation will eventually lead to ankylosing:the fixation of the spine via the fusion of vertebrae. This will lead to decreased spine mobility, decreased chest expansion, and inability to turn the head (when the neck is affected). 
  2. Hip pain: Hip pain is present in approximately 25% of patients with AS. It can be present in the groin, thighs, and sometimes knees. Other peripheral joints may also be affected, such as the ankles, shoulders, sterno-clavicular joints (located in the chest area), and even the temporo-mandibular joint (TMJ, located in the cheekbone). In fact, about half of patients with AS experience change in their TMJs, as can be seen via their CT scans.  Unfortunately, patients suffering from hip pain have a worse prognosis.
  3. Common Signs of Ankylosing Spondylitis
  4. Buttock Pain: About 40% of patients with AS present with alternating pain from one side to another of their buttock. Sometimes the pain is present on only one one side.
  5. Sausage digits -In medical terms, we use the term “dactylitis” instead of sausage digits. Some patients can present with diffuse swelling of one finger or one toe that is caused by the inflammation of the tendons. Dactylitis is hard to treat and requires a longer period of time to improve.
  6. Tendonitis – Inflammation of the tendons is very common in patients with AS. The most frequent tendons affected are the tendons of the elbows, Achilles tendons and also plantar fascia. Some patients can complain about swelling or redness over those tendons.
  7. Eye inflammation – One eye or both eyes can be affected in patients with AS. About 35% of patients get inflammation in their eyes.Patients can present with eye problems before the pain in the back starts. Most often they will complain of eye pain, they will not tolerate light or will have blurry vision. The treatment has to be done immediately as could lead to vision loss.
  8. Bowel disease – about ⅔ of patients with AS have inflammation in their gut. Also patients with inflammatory bowel diseases like Crohns or Ulcerative Colitis can develop a form of AS. This can lead to abdominal pain, bloating and diarrhea. If those symptoms are persistent, you need a colonoscopy to be evaluated further.

Navigating the medical system these days can be very challenging. If you have the proper medical support, education, and a true advocate on your side, your medical journey will become easier. Rheumatologist OnCall is a telemedicine company that offers support, diagnostic and the most advance therapeutic options for your disease in an affordable and transparent way, when you need it the most. No waiting time for months and no need to travel for tens or hundreds of miles. You can have a medical appointment from the comfort of your home.

If you are concerned about ankylosing spondylitis or another disease of your back or joints, please consult a rheumatologist that will be able to evaluate you further. If you want to learn more about this disease, like what is HLA -B27, how to diagnose ankylosing spondylitis or how to treat this disease, you can see more movies on my Youtube channel.

Contributors to this article:

Diana Girnita MD, PhD and Ana Girnita.


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