Ankylosing spondylitis - a chronic systemic rheumatic inflammation of the joints, especially the spine, with a sharp restriction of mobility of the patient, the formation at the joint surface boundary bone growths and ossification of ligaments.
inflammatory process sooner or later leads to the fact that the joint space disappears.This is what causes for which the patient is no longer able to perform a movement in that joint.Such a change is called ankylosis.Therefore, the second name of ankylosing spondylitis - ankylosing spondylitis. Content
Ankylosing spondylitis affects men 5 times more often than women.The peak incidence occurs in 15-30 years.Ankylosing spondylitis is diagnosed in children of primary school age (up to 15% of all cases).Perhaps the disease develops, and even earlier, but because of the blurring of symptoms and diagnosis of problems, identify ankylosing spondylitis in children is not always possible.Individuals of retirement age do not get sick, so it's safe to say that ankylosing spondylitis - the lot of young people.Because of the severity of the disease over time, patients are unable to work and become disabled.Quality of life is progressively reduced, the physical suffering of the patient adds significant psychological distress.
pathological process extends to the sacroiliac joints, spine, joints and intervertebral disks, peripheral joints (interphalangeal), the ligaments of the spine.
Classic Home - defeat the sacroiliac joints (sacroiliitis), then the intervertebral discs and joints.This leads to the formation of the symptom "bamboo stick".Movement in the spine become absolutely impossible, just a person can neither bend nor straighten up.
Ankylosing spondylitis - a systemic disease.This means that the process involves not only the joints and tendons, and other tissues and organs.A quarter of patients formed iritis and iridocyclitis (inflammation of the iris and ciliary body of the eye), which can lead to glaucoma.In 10% of patients affected conduction system of the heart (may develop a partial or complete blockage) heart valves (the formation of acquired defects) artery.In some cases, ankylosing spondylitis may provoke the development of lung fibrosis tops, with the formation of cavities, making it difficult to diagnose, since such a process is very similar to the X-ray tuberculosis.
difficulty of diagnosis at the initial stage is shown by the fact that the onset of the disease is often subclinical it passes almost unnoticed, but possible symptoms are very diverse and rheumatologist suggest thinking about other systemic diseases.
most often begins with ankylosing spondylitis arthritis.70% of patients affected one or 2-3 peripheral joints (knees, joints of the hand).They become red, swollen and sore.It's more like an isolated arthritis, but not ankylosing spondylitis.Only 15% say the discomfort in the lower back (the defeat of the sacroiliac joints).
10% of patients within a few weeks or months before the onset of joint problems develop iritis or iridocyclitis.
pain syndrome.For ankylosing spondylitis is characterized by a gradual increase in the intensity of pain and its distribution.Initially, patients may observe stiffness in the lower back, neck, or back in the morning, which is held once a person "at odds".Some patients say the pain in the heels.Over time, the pain gets inflammatory character, the peak of its accounts for 3-5 hours at night.
Due to the fact that the onset of the disease may be very different, have identified a number of options debut:
Due to the fact that the manifestations of ankylosing spondylitis, such a varied and mimic other diseases, timely diagnosis is much more difficult.
In primary survey of the patient can not identify the typical ankylosing spondylitis disorders.However, a detailed and careful questioning will help to know that the patient is in the morning stiffness in the back, waist or neck, which is held during the day.On examination, attention is drawn to the reduced mobility of the chest when breathing, limitation of movement in the spine.
to detect sacroiliitis.
samples to determine the limits of mobility.
goals of treatment of patients with ankylosing spondylitis - a reduction of pain and inflammation, prevent and reduce the stiffness of the spine, the preservation of the activity of the patient.
Treatment should be consistent and proportionate to the gravity of the process.It is best to regularly observed in the patient in the clinic rheumatologist and in acute hospital hospitalized in profile.
Nonsteroidal anti-inflammatory drugs (NSAIDs).
are divided into nonselective (inhibiting cyclooxygenase-1 and cyclooxygenase-2) and non-selective (inhibit only COX-2).Patients received drugs from both groups.
In severe forms of the disease and the ineffectiveness of the NSAID patients prescribed hormones.The main drug - methylprednisolone.For corticosteroids characterized by a strong inflammatory effect.Patients taking hormones, noted a significant reduction in pain, reduction of the intensity of inflammation, until complete remission.
most popular drugs in this group is sulfasalazine.It is administered in a dose of 3 mg per day, has a marked anti-inflammatory effect.
Methotrexate for more than 50 years, rheumatologists prescribe to their patients.Despite the potential carcinogenic effects, this drug is considered one of the strongest anti-inflammatory drugs.
When treatment failure is sometimes prescribe drugs that suppress the immune response: azathioprine, cyclophosphamide.
These drugs were originally synthesized for the treatment of cancer patients, but then they have been identified in addition to the immunosuppressive interesting "side effect".These drugs block the body substances involved in inflammation cycles (e.g., tumor necrosis factor).For biological agents include infliximab (Remicade), rituximab, etanercept, Adalimumab.
significant drawback of these drugs - their high cost.
main method of treatment of functional insufficiency of the joints is regular exercise.Each patient doctor LFK selects a set of exercises in accordance with the form and stage of the illness.Therapeutic exercises need to deal with 1-2 times a day for 20-30 minutes.In remission positive effect is swimming and skiing.
good analgesic and anti-inflammatory effect has physiotherapy.Patients with the disease are appointed spondylitis:
Ankylosing spondylitis, as well as any other rheumatic disease can not be cured.The main goal is a rheumatologist and patient - long periods of remission.To do this, you need to carefully monitor themselves carefully carry out all medical appointments, do not miss the next examination and hospitalization.
With the right approach, patients with Bechterew's disease for many years lived a full life, keep working, do not feel limited or special.
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