Ankylosing spondylitis history and symptoms
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Ankylosing spondylitis typically presents in a young patient with chronic pain and stiffness in the lower part of the spine. In 40% of the cases, ankylosing spondylitis is associated with iridocyclitis (anterior uveitis, also known as iritis) causing eye pain and photophobia (increased sensitivity to light). Other common symptoms include recurring mouth ulcers (aphthae) and fatigue.
The typical patient is young, of 15 to 30 years of age with chronic pain and stiffness in the lower part of the spine. Men are affected more than women by a ratio in excess of 2:1. In 40% of cases, ankylosing spondylitis is associated with iridocyclitis (anterior uveitis, also known as iritis) causing eye pain and photophobia (increased sensitivity to light). Other common symptoms are recurring mouth ulcers (aphthae) and fatigue. Pain fluctuation from one side to the other.
Typical prodromes (early symptoms) may occur at a very young age (e.g. 3 years old), where the patient may experience recurring painful joints (e.g. knees, elbows), commonly misinterpreted as simple rheumatism.
- Chronic pain and stiffness in lower back and hips, especially in the morning and after periods of inactivity. As disease progresses, symptoms get worse and one may feel pain and stiffness over time.
- Joint pain
- Joint swelling
- Stiff, inflexible spine
- Eye inflammation or uveitis
- Restricted expansion of your chest
- Low fever
- Loss of appetite
- Weight loss
The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), developed in Bath (Somerset,UK) is an index designed to detect the inflammatory burden of active disease. The BASDA can help to establish a diagnosis of AS in the presence of other factors such as HLA-B27 positivity, persistent buttock pain which resolves with exercise, and X-ray or MRI evident involvement of the sacroiliac joints.  It can be easily calculated and accurately assesses a patient's need for additional therapy; a score of 4 out of a possible 10 points while on adequate NSAID therapy is usually considered a good candidate for biologic therapy.
The Bath Ankylosing Spondylitis Functional Index (BASFI) is a functional index which can accurately assess a patient's functional impairment due to the disease, as well as improvements following therapy. The BASFI is not usually used as a diagnostic tool, but as a tool to establish a patient's current baseline and subsequent response to therapy.
- Garrett S, Jenkinson T, Kennedy L, Whitelock H, Gaisford P, Calin A (1994). "A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index.". J Rheumatol. 21 (12): 2286–91. PMID 7699630.
- Calin A, Garrett S, Whitelock H, Kennedy L, O'Hea J, Mallorie P, Jenkinson T (1994). "A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Spondylitis Functional Index.". J Rheumatol. 21 (12): 2281–5. PMID 7699629.