The expert highlights the importance of being able to differentiate this disease from other spondyloarthropathies.
Doctor Paloma Alejandro Silva, rheumatologist Soto-Raíces Mindful Rheumatix & Medical Research Group. Photo: Journal of Medicine and Public Health. Fabiola Plaza.
In an exclusive interview with the Journal of Medicine and Public Health, Dr. Paloma Alejandro, a rheumatologist at Soto-Raíces Mindful Rheumatix and Medical Research Group, highlighted that the ankylosing spondylitis it is a pathology even rarer than rheumatoid arthritis or lupus in which there is systemic inflammation and for that reason a multifactorial diagnosis must exist.
Experts usually involve different studies such as blood tests, diagnostic imaging tests, erythrocyte sedimentation rate and CRP levels to rule out conditions such as rheumatoid arthritis or systemic autoimmune diseases such as lupus.
“In terms of imaging, we like to start with films to see if there are changes in arthritis, but this is a diagnostic modality where we’re going to see changes following 20 years of the condition. So, if that plaque comes out normal, we should not think that the patient has nothing, we should be suspicious of doing more specific tests, such as an MRI, “said the specialist.
Likewise, when talking regarding the treatments available for these patients, it is important to emphasize that, in recent years, the Food and Drug Administration (FDA) has approved different medications that help improve symptoms and prevent the condition generates high levels of deterioration.
“Patients with this pathology are often referred by spine orthopedists following they have been operated on, but they did not realize that people suffered from this disease,” concluded the Dr. Paloma Alejandro. “It is very sad to see patients who have a lot of surgeries on the spine and, perhaps, by treating them with medication, these procedures might have been avoided.”
Ankylosing Spondylitis: Clinical Definition
“Due to genetic and environmental factors, the immune system begins to attack the spine, mainly the neck, the lumbar area and the sacrum. Inflammation, over time, causes a lot of damage to the spine and fibrosis, which destroys the joints and patients lose mobility”, explained the rheumatologist.
The specialist highlighted that the medical literature defines the ankylosing spondylitis as an inflammatory disease that, if not controlled in time, can cause fusion of the lumbar vertebrae. This complication stiffens the spine and can stimulate the development of a stooped posture.
Among the first signs and symptoms of this disease is pain and stiffness in the lower back and hips, particularly in the morning and following periods of inactivity; neck pain and tiredness.
“It is a condition that tends to affect men more, between the ages of 20 and 30, but unfortunately, due to the lack of diagnosis, it can be detected at 40 or 50 years of age, that is, following many years of symptoms” .
Low back pain is usually very characteristic of this condition, and should be taken into account when the patient turns to the primary care physician, in this way, being able to discern inflammatory pain, which usually disappears with exercise, responds effectively to anti-inflammatories and causes stiffness , of the conical-mechanical pains, which are not relieved with anti-inflammatories, usually appear during the day and worsen with physical activity: “It is important to distinguish these patients, and to be suspicious of deciding that you are going to do more imaging studies, blood tests to diagnose it.
overcoming the diagnosis ankylosing spondylitis
Elvin Villegas recounted his experience as a patient of this disease. He commented that the first manifestation was uveitis, since it is an ocular condition conditioned by autoimmune or inflammatory disorders that can affect one or both eyes.
“I woke up one day with a blank eye, I mightn’t see. That morning I went to the specialist to do a lot of tests, and through those tests I came out with the sciatic nerve caught through the eye and there they detected uveitis, ”he said.
Villegas also mentioned that he has had the symptoms for approximately 10 years, however, despite his diagnosis, he assures that thanks to the treatment and the adaptation of healthy habits, he was able to recover his quality of life.
“Once I was diagnosed, I started to feel very stiff, I mightn’t get up well, my neck hurt and I mightn’t bend over either. But the recovery process has been favorable thanks to the adherence to the treatment, the incorporation of exercise and a healthy diet”, she emphasized.
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