Very often you can meet people who are worried about back pain. But, as a rule, while it is not strong and does not interfere with daily life, we ignore such symptoms, writing off them for fatigue and physical overstrain. Nevertheless, if the pain in the spine worries you for a long time and does not pass after rest, is accompanied by other alarming signs, it is necessary to visit a doctor.
In 80% of cases, the causes of soreness are really trifling and do not carry danger, but in other cases it can indicate a serious disease that requires intensive treatment. One of such pathologies is ankylosing spondylitis. The first symptoms of Bechterew's disease often go unnoticed, and meanwhile the ailment does its job, which in the end can lead to severe disability, and sometimes to death.
Definition of the disease
Ankylosing spondylitis, or ankylosing spondylitis, is a chronic, progressive disease that belongs to the group of system pathologies, with a predominant lesion of the inflammatory nature of the vertebral joints, iliac articulations, the parotid tissue( ligament and muscle)at the late stages of various internal organs and peripheral joints. As the disease progresses, ankylosis develops( joint overgrowth by the gross connective tissue) of the joints and calcification of the vertebral ligaments, which leads to a sharp limitation of mobility in the affected structures and to their ugly deformations.
The prevalence of the disease reaches 0.5-2%, affects mainly young men aged 15 to 40 years, the ratio of sick women to men is 1 to 9.
In the late stages of Bechterew's disease there is a complete infection of vertebral joints( ankylosis), whichleads to deformations
In clinical practice, several classifications of ankylosing spondylitis are used, which reflect symptoms, the stage of the disease, its activity, take into account complications and consequences.
Depending on the clinical course, the following are distinguished:
- is a slowly progressing variant( most favorable);
- variant, which slowly progresses, but with periods of exacerbation and weighting of signs of pathology;
- symptoms of Bechterew's disease progress rapidly and in a short time lead to ankylosis and disability;
- is a variant of septic flow with severe general symptoms and early development of severe lesions of the internal organs, which often results in the death of the patient in a short time.
In the photo "Pose of the petitioner", which develops at the late stage of the pathology of
. There are three stages of the disease:
- The early stage, which often goes unnoticed. Signs are very scarce - mild pain in the affected spine and some limitation of mobility, which is difficult to notice when performing everyday tasks( only with the help of special functional tests).To diagnose the process at the initial stage will help only radiography.
- Expanded stage. As a rule, it is during this period that patients seek medical help and diagnose spondylarthrosis. Clinical symptoms are expressed and varied. Patients are worried about chronic pain in the affected joints and a significant limitation of movements in them.
- The late stage is characterized by pronounced ankylosing and ossification of the affected structures. Deformations of the spinal column typical for Bekhterev's disease( "bamboo stick" and "petitioner's posture") develop, internal organs are drawn into the pathological process.
Depending on the indicators of laboratory tests( ESR, SRB, disproteinemicheskie samples) and the severity of clinical symptoms, identify three levels of activity of the process. There are also three degrees of functional failure of the joints. The second degree of the FNS meets the 3 disability groups, and the third degree of the FNS - 2 and 1 group of disability.
Clinical features of
Early diagnosis is a very important and important task. Although the patient can not be cured of pathology at the moment, the existing medications and therapies allow slowing the progression of Bechterew's disease and delaying( sometimes for several decades) the function of joints and disability. Therefore, the first thing to look for is the first signs of ankylosing spondylitis:
- is a gradual onset of the disease in most cases;
- development of sacroiliitis is an inflammation of the iliac articulation, appears first, characterized by pains in the buttocks and sacrum, the patient is pained to sit on a hard surface, the pain is bilateral, constant, intensified at night, it rarely has an intense character, so it goes unnoticed;
- sensation of stiffness and stiffness in the affected part of the spine, its peak falls in the morning, after active movements such feelings for a time disappear;
- may appear dull ache in the back;
- with a careful examination can be noted smoothing physiological curves of the spine, reducing the amplitude of movements of the chest, head;
- may vary the patient's gait.
Back pain can be the first sign of ankylosing spondylitis
As a rule, very rarely anyone comes to a specialist with the above complaints, because the disease is diagnosed more often at the stage of a detailed clinical picture. The pain becomes intense and constant, does not allow to fall asleep at night, it is not removed by usual analgetics. Deformations of various parts of the spine develop( "pose of the petitioner"), its bends disappear( symptom of the "bamboo stick"), the patient sometimes can not even turn his head or bend at least 5 cm.
In the pathological process peripheral joints are involved with the development of arthritis in them, internal organs( eyes, kidneys, heart, lungs, nerves and vessels) with the development of the corresponding symptoms. Such lesions are difficult to treat and often cause the death of patients with ankylosing spondylarthrosis.
Video about Bechterew's Disease:
How to establish a diagnosis?
In the diagnosis of Bechterew's disease, the following methods are used:
- functional tests for the determination of sacroileitis and latent restriction of joint mobility( Kushelevsky 1, 2 and 3, Makarova 1 and 2, Zatsepina, Forestesti, Otta, Vereshchakovskiy, Shober, Tomaer test, vertebralindex, etc.);
- X-ray examination, if necessary, conduct CT and MRI;
- examination of other organs that may be involved in the pathological process;
- laboratory tests( determination of carriage HLA B27, ESR, CRP, dysproteinemic tests, functional state of the immune system).
Radiography of the iliac articulations will help diagnose ankylosing spondylitis at an early stage of
If you are concerned about constant back pain, which is accompanied by a restriction of mobility in the joints, be sure to seek medical help. The correct diagnosis is already half the treatment, and if it is delivered on time, the success of treatment is significantly increased.
- Classification and disease stages
- Clinical features