This condition is frequently diagnosed in young men and can even start as young as 20 years old.
Dr. Amarilis Pérez de Jesús, rheumatologist. Photo: Journal of Medicine and Public Health.
The Back pain may go unnoticed by many patients, however, this is a characteristic symptom of ankylosing spondylitisan autoimmune condition, which affects the spine and joints large size of the human body.RELATED
To learn more about this disease, Dr. Amarilis Pérez de Jesús, rheumatologist and member of the board of directors of the Foundation for Rheumatic Diseases (FER), explained to the Journal of Medicine and Public Health the main characteristics and symptoms of the patients, in addition to the diagnostic process and treatment alternatives to prevent the progression of Ankylosing Spondylitis.
This is a less common condition than arthritis psoriatic, but it falls within the group of conditions known as spondyloarthropathies. “It occurs more commonly in young men, who can begin to develop the disease at the age of 20. A distinctive feature is the patient who complains of back pain, in the sacroiliac area, we identify that, but what the patient says is that he has pain in his lower back,” he explained.
In addition, he emphasized that back pain is worse in the morning and improves during the day, contrary to mechanical back pain that worsens as the patient engages in physical activity.
In a young man who wakes up with back pain in the morning, “that stiffness can last 30 minutes,” he added. “We can only have involvement in the spine or peripheral arthritis, that is, they have inflammation in joint areas, such as hands, feet, etc.”, he specified.
On the other hand, he mentioned that ankylosing spondylitis is also diagnosed in women, although it does not occur frequently. “I want to clarify that it is a condition that is also seen in women and perhaps it is not as common because it was not being diagnosed as much in women, since many times it has been managed similar to conditions such as fibromyalgia, since the picture can be confused by the area of pain or enthesitis,” explained the specialist.
“If we see them in females, it is not as common, but today we are identifying it more compared to years ago,” he added.
To reach a diagnosis of ankylosing spondylitis, specialists take into account the patient’s physical examination, symptoms, history, and screening tests.
“We have an associated gene, HLAP27, therefore, it is a condition that has a genetic contribution. I saw a patient last week who began to read about his back pain, he is 37 years old, he is a young patient, and the He himself asked his primary doctor to do the HLAP27 test, and it came out positive, he told me he had ankylosing spondylitis, however, we made the diagnosis through history, physical examination and other findings” narrated Dr. Amarilis .
Although the cause of this condition is unknown, the specialist affirms that it is important to take into account the patient’s history and previous evaluations. “As part of the patient evaluation, we may find pain in the sacroiliac area, we may have the enthesitis, which is pain at the attachment of the ligaments to the bone, like we see in psoriatic arthritis,” she added.
On this, he explained that in diagnostic tests they perform the HLAP27 test, which is a histocompatibility antigen and in most cases of ankylosing spondylitis the result will be positive, as in the patient he attended.
They also do inflammation tests, X-rays, particularly of the sacroiliac area, and in many cases, if they come out negative, they resort to magnetic resonance imaging, which already identifies patients who are in an early stage, where radiologically no changes are observed, but the patient if you have symptoms.
“Once we establish the diagnosis, we proceed to treat the patient. It is important to point out that if a patient does not receive treatment for ankylosing spondylitis, their spinal column can be fused and they will lose functional capacity, affecting their daily lives. Our goal as rheumatologists is to manage that patient to prevent it from reaching that damage because once we have the damage it is permanent,” stressed the rheumatologist.
For this, early treatment is essential, as in any rheumatological condition. Currently, there are different alternatives of treatments What:
“Today we have a range of treatments that are much more sophisticated where we are going to try to block or reduce the presence of these substances that are pro-inflammatory. We have interleukin inhibitors that, depending on the stage, we start with the treatment and usually the patients respond well and her quality of life may be normal within her condition” underlined Dr. Pérez.
Finally, he highlighted the importance of physical therapy in patients, to help the joints have good movement and fulfill their function in the body, avoiding deterioration.
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