Ankylosing spondylitis

Nursing Medical Surgical Topic

1. Ankylosing Spondylitis

2. Definition "Ankylosis" means fused bones or other hard tissue. "Spondylitis" means inflammation in your spinal bones, or vertebrae. Ankylosing spondylitis is an inflammatory disease that, over time causes the small bones of spine (vertebrae) to fuse.  Ankylosing spondylitis (AS) is a type of arthritis in which there is a long-term inflammation of the joints of the spine.

3. Incidence Ankylosing spondylitis affects men more often than women. Signs and symptoms typically begin in early adulthood. Inflammation also can occur in other parts of your body — most commonly eyes.

4. Etiology Ankylosing spondylitis has no known specific cause, though genetic factors seem to be involved. In particular, people who have a gene called HLA-B27 are at a greatly increased risk of developing ankylosing spondylitis.

5. Risk Factor Sex. Men are more likely to develop ankylosing spondylitis than are women. Age. Onset generally occurs in late adolescence or early adulthood. Heredity. Most people who have ankylosing spondylitis have the HLA-B27 gene.

6. Clinical Manifestations Initial symptoms are usually a chronic dull pain in the lower back or gluteal region combined with stiffness of the lower back. Individuals often experience pain and stiffness that awakens them in the early morning hours. As the disease progresses, loss of spinal mobility and chest expansion, with a limitation of anterior flexion, lateral flexion, and extension of the lumbar spine, are seen. Systemic features are common, with weight loss, fever, or fatigue often present.

7. Stages

8. Diagnostic Evaluations Physical Examination Imaging tests- X-Ray, MRI Lab tests- No Specific Lab Test, ESR can be checked for inflammation and Genetic testing of HLA-B27 gene

9. Management There is no cure for AS, although treatments and medications can reduce symptoms and pain. The major types of medications used to treat ankylosing spondylitis are pain-relievers and drugs aimed at stopping or slowing the progression of the disease. Anti-inflammatory drugs, which include nsaids such as ibuprofen, phenylbutazone, diclofenac, indomethacin, naproxen Disease-modifying antirheumatic drugs ( dmards ) such as sulfasalazine can be used in people with peripheral arthritis. Anti-interleukin-6 inhibitors such as tocilizumab, currently approved for the treatment of rheumatoid arthritis. Interleukin-17a inhibitor secukinumab is an option for the treatment of active ankylosing spondylitis.

10. Surgical Management In severe cases of AS, surgery can be an option in the form of joint replacements, particularly in the knees and hips.

11. Nursing MANAGEMENT Make time to exercise every day, even a few minutes at a time. Keeping a healthy weight A diet high in omega-3 fatty acids might help. Don’t smoke. People who smoke tobacco often have symptoms that get worse as they get older. Manage stress with things like massage, yoga, meditation, and counseling. Apply heat to stiff joints and tight muscles and use cold on inflamed areas.