Ankylosing Spondylitis: Introduction FeedbackA general introduction to Ankylosing Spondylitis.Source: Clinical Knowledge Summaries, 01 Feb 2013
Ankylosing spondylitis is a chronic inflammatory rheumatic disease of unknown cause and varying clinical presentation. The principal features (not all of which are present at onset, or in all people) are:
Inflammatory low back pain, (pain and stiffness worse at night and in the morning).
Inflammation of the spinal joints and the junction (enthesis) of the intervertebral spinal ligaments and vertebrae, leading (after many years) to ankylosis (i.e. fusion from fibrosis and calcification).
Inflammation of the sacroiliac joints (on X-ray or other radiological imaging such as MRI), which presents as alternating buttock pain.
Enthesitis (inflammation of the sites where tendons and ligaments attach to bone), costochondritis (inflammation where cartilage joins the ribs), and epicondylitis (inflammation of an epicondyle of bone).
Arthritis of peripheral joints, usually involving the large joints of the lower limbs, or asymmetric arthritis of peripheral joints.
Insidious onset (over a period of at least 3 months, and often several years) usually beginning in late adolescence or early adulthood.
Association with the human leukocyte antigen B27 (HLA-B27).
Ankylosing spondylitis is not uncommon:
About 2% of people in a general practice will present with back pain and up to 5% of these will show features of ankylosing spondylitis.
It is about three times more common in men than women.
It most commonly begins between 20 and 30 years of age, but also occurs in children and older adults.
Common complications include:
Progressive involvement of the lumbar, thoracic, and cervical spine, leading to a fixed and flexed posture.
Damage to peripheral joints.
Anterior uveitis (iritis).
If ankylosing spondylitis is suspected:
The presence of inflammation should be confirmed with erythrocyte sedimentation rate (ESR), and/or C-reactive protein (CRP), and full blood count (FBC) tests.
Local referral protocols should be followed on imaging the sacroiliac joints and spine, or specialist advice sought on imaging before referral. In well-established cases, radiographs of the sacroiliac joints and spine are diagnostic. Magnetic resonance imaging can detect early changes in sacroiliac joints. Ultrasound scanning can confirm a clinical impression of enthesitis.
Referral to a rheumatologist should be arranged.
Treatment should be started with a nonsteroidal anti-inflammatory drug (NSAID).
Treatments available from rheumatologists for ankylosing spondylitis include:
For sacroiliitis: injection of corticosteroids.
For enthesitis (inflammation where bone joins tendon or ligament): injection of corticosteroids.
For uncontrolled disease in general: tumour necrosis factor (TNF)-alpha inhibitors such as etanercept and adalimumab or oral or intravenous bisphosphonates.
Ankylosing Spondylitis: Guidance FeedbackThe most relevant search results for Ankylosing Spondylitis from producers of guidance information.
Information for the public
Ankylosing Spondylitis: Information for the public FeedbackThe most relevant search results for Ankylosing Spondylitis, from Department of Health accredited producers of patient information.
- Bupa , 27 June 2014
- NHS Choices, 26 June 2014
- NHS Choices, 03 July 2014
- NHS Choices, 21 February 2014
- NHS Choices, 21 February 2013
- NHS Choices, 23 July 2014
- NHS Choices, 23 July 2014
- Cancer Research UK, 11 February 2014
- Patient UK
- Patient UK
Ankylosing Spondylitis: Medicines FeedbackAppropriate medicines information for Ankylosing Spondylitis supplied by Datapharm, a leading source of trusted, credible information about medicines.
Ankylosing spondylitis - Medicines Information
- Anadin Ibuprofen (a brand of Ibuprofen)
- Anadin Paracetamol (a brand of Paracetamol)
- Brufen (a brand of Ibuprofen)
- Celebrex (a brand of Celecoxib)
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- Depo-Medrone (a brand of Methylprednisolone Acetate)
- Depo-medrone with Lidocaine (a brand of Lidocaine , a brand of Methylprednisolone Acetate)
- Dexomon (a brand of Diclofenac Sodium)
- Diclofenac sodium
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- Diclomax (a brand of Diclofenac Sodium)
- Econac (a brand of Diclofenac Sodium)
- Etoricoxib (a generic version of Arcoxia)
- Feldene (a brand of Piroxicam)
- Froben (a brand of Flurbiprofen)
- Humira (a brand of Adalimumab)
- Hydrocortisone acetate
- Hydrocortistab (a brand of Hydrocortisone Acetate)
- Indolar (a brand of Indometacin)
- Ketocid (a brand of Ketoprofen)
- Ketovail (a brand of Ketoprofen)
- Lidocaine/Methylprednisolone acetate
- Medrone (a brand of Methylprednisolone)
- Methylprednisolone acetate
- Motifene (a brand of Diclofenac Sodium)
- Napratec (a brand of Misoprostol , a brand of Naproxen)
- Nurofen (a brand of Ibuprofen)
- Pardelprin (a brand of Indometacin)
- Preservex (a brand of Aceclofenac)
- Tiaprofenic Acid
- Tylex (a brand of Codeine , a brand of Paracetamol)
- Voltarol (a brand of Diclofenac Sodium)
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- Voltarol Rapid (a brand of Diclofenac Potassium)
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...Twitter Facebook Email More... Ankylosing spondylitis Ankylosing spondylitis D013167Spondylitis, Ankylosing Musculoskeletal...02-01Last revised in February 2013 Ankylosing spondylitis - Summary Ankylosing spondylitis is...
Clinical Knowledge Summaries, 01 February 2013
...content Methotrexate for ankylosing spondylitis Junmin Chen 1...Lin J. Methotrexate for ankylosing spondylitis. Cochrane Database of Systematic...Description of the condition Ankylosing spondylitis (AS) is a type of arthritis...
Cochrane Database of Systematic Reviews, 28 February 2013 - Publisher: John Wiley & Sons, Ltd
...Physiotherapy interventions for ankylosing spondylitis Hanne Dagfinrud 1...Physiotherapy interventions for ankylosing spondylitis. Cochrane Database of Systematic...support Index terms Ankylosing spondylitis (AS) is a chronic, progressive...
Cochrane Database of Systematic Reviews, 23 January 2008 - Publisher: John Wiley & Sons, Ltd
...content Sulfasalazine for ankylosing spondylitis Junmin Chen 1...Liu C. Sulfasalazine for ankylosing spondylitis. Cochrane Database of Systematic...interest Index terms Ankylosing spondylitis (AS) is a chronic inflammatory...
Cochrane Database of Systematic Reviews, 20 April 2005 - Publisher: John Wiley & Sons, Ltd
...treatment of severe, active ankylosing spondylitis in adults only if: it...etanercept and infliximab for ankylosing spondylitis' (NICE technology appraisal...treatment of severe, active ankylosing spondylitis who do not fulfil the criteria...
National Institute for Health and Care Excellence, 01 August 2011
Indirect comparison of the effects of anti-TNF biological agents in patients with ankylosing spondylitis by means of a mixed treatment comparison performed on efficacy data from published randomised, controlled trials
...agents in patients with ankylosing spondylitis by means of a mixed treatment...arthritis of the spinal joints (ankylosing spondylitis). The paucity of evidence...arthritis of the spinal joints (ankylosing spondylitis). Searching MEDLINE...
Database of Abstracts of Reviews of Effects, 13 November 2012
Adalimumab, etanercept and infliximab for the treatment of ankylosing spondylitis: a systematic review and economic evaluation
...infliximab for the treatment of ankylosing spondylitis: a systematic review and...therapy for patients with ankylosing spondylitis, concluded that the therapy...infliximab) for the treatment of ankylosing spondylitis. This abstract will only...
Database of Abstracts of Reviews of Effects, 01 December 2008
Combination therapy for pain management in inflammatory arthritis (rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, other spondyloarthritis)
...rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis...rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis...rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis...
Cochrane Database of Systematic Reviews, 05 October 2011 - Publisher: John Wiley & Sons, Ltd
The burden of ankylosing spondylitis and the cost-effectiveness of treatment with infliximab (Remicade)
... NIHR The burden of ankylosing spondylitis and the cost-effectiveness...weeks, in the treatment of ankylosing spondylitis (AS). Type of intervention...term model tracked the Bath Ankylosing Spondylitis Disease Activity Index...
NHS Economic Evaluation Database, 31 December 2005
...adalimumab for the treatment of ankylosing spondylitis in the United Kingdom ...therapy for the treatment of ankylosing spondylitis. The authors concluded that...effectiveness of two treatments for ankylosing spondylitis. Interventions The...
NHS Economic Evaluation Database, 03 March 2010
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