{"id":3105,"date":"2022-08-22T10:50:00","date_gmt":"2022-08-22T02:50:00","guid":{"rendered":"https:\/\/hkerdr.com\/%e5%bc%b7%e7%9b%b4%e6%80%a7%e8%84%8a%e6%a4%8e%e7%82%8e\/"},"modified":"2022-10-11T20:27:31","modified_gmt":"2022-10-11T12:27:31","slug":"ankylosing-spondylitis","status":"publish","type":"post","link":"https:\/\/umghk.com\/en\/ankylosing-spondylitis\/","title":{"rendered":"Ankylosing Spondylitis"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"background-color: rgba(255,255,255,0);background-position: center center;background-repeat: no-repeat;padding-top:0px;padding-right:10px;padding-bottom:0px;padding-left:10px;margin-bottom: 0px;margin-top: 0px;border-width: 0px 0px 0px 0px;border-color:#eae9e9;border-style:solid;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"margin-top:0px;margin-bottom:30px;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div class=\"fusion-text fusion-text-1\"><p style=\"text-align: left;\" align=\"JUSTIFY\">Ankylosing spondylitis (AS) is a chronic inflammatory joint disease that can gradually affect the joints and ligaments of the spine, as well as other parts of the body. Classically, the primary site of involvement is both sides of the sacroiliac (SI) joints which then ascends the spine into the thoracolumbar region, rib articulations and the cervical spine. Fusion of the bones and ossification of ligaments in the spine generally leads to the loss of the natural curvature of the spine (becoming more hunched), and its mobility \u2013 this is also usually accompanied with pain due to inflammation. While AS commonly affects the axial skeleton, it is also known to affect the appendicular skeleton in approximately one-third of patients with AS, such as the knees and hips (arthritis), and Achilles tendon (enthesitis).<\/p>\n<p style=\"text-align: left;\" align=\"JUSTIFY\"><b>Meaning: <\/b>\u2018Ankylosis\u2019 means the abnormal stiffening and reduction of mobility of a joint due to fusion of the bones. \u2018Spondylitis\u2019 can be better understood as the inflammation of the vertebrae (spinal bones).<\/p>\n<\/div><style type='text\/css'>.reading-box-container-1 .element-bottomshadow:before,.reading-box-container-1 .element-bottomshadow:after{opacity:0.70;}<\/style><div class=\"fusion-reading-box-container reading-box-container-1\" style=\"margin-top:0px;margin-bottom:10px;\"><div class=\"reading-box\" style=\"background-color:#f6f6f6;border-width:3px;border-color:#f6f6f6;border-left-width:3px;border-left-color:var(--primary_color);border-style:solid;\"><div class=\"reading-box-additional\">\n<h2>Aetiology<\/h2>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-text fusion-text-2\"><p>The specific cause to AS is still unknown at the moment, though AS has been linked with a gene known as human leukocyte antigen B27 (HLA-B27). It is thought that carrying the gene may make someone more vulnerable to developing the disease, and it may also be triggered by one or more environmental factors, but it is still unknown what these are. Thus, testing positive for this gene does not necessarily mean that one would develop AS because only 1-2% of people with the gene will develop the disease.<\/p>\n<\/div><style type='text\/css'>.reading-box-container-2 .element-bottomshadow:before,.reading-box-container-2 .element-bottomshadow:after{opacity:0.70;}<\/style><div class=\"fusion-reading-box-container reading-box-container-2\" style=\"margin-top:0px;margin-bottom:10px;\"><div class=\"reading-box\" style=\"background-color:#f6f6f6;border-width:3px;border-color:#f6f6f6;border-left-width:3px;border-left-color:var(--primary_color);border-style:solid;\"><div class=\"reading-box-additional\">\n<h2>Risk Factors<\/h2>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-text fusion-text-3\"><p style=\"text-align: left;\" align=\"JUSTIFY\">However, AS has a strong familial tendency in which the HLA-B27 gene can be inherited from another family member. If a parent has AS and the HLA-B27 gene, then there is a 50% chance of passing the gene down to any offspring \u2013 about 5-20% of children with this gene will then go on to develop AS. Males are also more likely to develop this disease than females with a ratio of 3:1.<\/p>\n<\/div><style type='text\/css'>.reading-box-container-3 .element-bottomshadow:before,.reading-box-container-3 .element-bottomshadow:after{opacity:0.70;}<\/style><div class=\"fusion-reading-box-container reading-box-container-3\" style=\"margin-top:0px;margin-bottom:10px;\"><div class=\"reading-box\" style=\"background-color:#f6f6f6;border-width:3px;border-color:#f6f6f6;border-left-width:3px;border-left-color:var(--primary_color);border-style:solid;\"><div class=\"reading-box-additional\">\n<h2>Presenting Symptoms<\/h2>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_2_3 2_3 fusion-two-third fusion-column-first\" style=\"width:66.666666666667%;width:calc(66.666666666667% - ( ( 4% ) * 0.66666666666667 ) );margin-right: 4%;margin-top:0px;margin-bottom:30px;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div class=\"fusion-text fusion-text-4\"><p style=\"text-align: left;\" align=\"JUSTIFY\">The symptoms of AS can vary from person-to-person, but they usually develop slowly, over several months or years. AS usually first starts to develop during later teenage years or early adulthood, with peak onset at 15-25 years of age. Most patients experience mild, continuous episodes of pain and stiffness with periods of remission. Symptoms to look out for:<\/p>\n<ul>\n<li>Fatigue<\/li>\n<li>Back pain and stiffness that gets better with activity or exercise <u>but<\/u> does not improve or becomes worse with inactivity or rest<\/li>\n<li>Morning stiffness in the affected region that lasts for more than 30 minutes<\/li>\n<li>Pain and stiffness that is worse in the morning and at night<\/li>\n<li>Pain around the buttocks<\/li>\n<li>Chest pain and difficulty in expanding the chest when inhaling deeply<\/li>\n<li>Pain and swelling in other parts of the body<\/li>\n<\/ul>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-2 fusion_builder_column_1_3 1_3 fusion-one-third fusion-column-last\" style=\"width:33.333333333333%;width:calc(33.333333333333% - ( ( 4% ) * 0.33333333333333 ) );margin-top:0px;margin-bottom:30px;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><span class=\" fusion-imageframe imageframe-none imageframe-1 hover-type-none\"><img decoding=\"async\" width=\"450\" height=\"600\" alt=\"\u5f37\u76f4\u6027\u810a\u690e\u708e\" title=\"\u5f37\u76f4\u6027\u810a\u690e\u708e\" src=\"https:\/\/umghk.com\/wp-content\/uploads\/2022\/08\/\u5f37\u76f4\u6027\u810a\u690e\u708e.png\" class=\"img-responsive wp-image-3106\" srcset=\"https:\/\/umghk.com\/wp-content\/uploads\/2022\/08\/\u5f37\u76f4\u6027\u810a\u690e\u708e-200x267.png 200w, https:\/\/umghk.com\/wp-content\/uploads\/2022\/08\/\u5f37\u76f4\u6027\u810a\u690e\u708e-400x533.png 400w, https:\/\/umghk.com\/wp-content\/uploads\/2022\/08\/\u5f37\u76f4\u6027\u810a\u690e\u708e.png 450w\" sizes=\"(max-width: 1050px) 100vw, 400px\" \/><\/span><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-3 fusion_builder_column_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"margin-top:0px;margin-bottom:30px;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><style type='text\/css'>.reading-box-container-4 .element-bottomshadow:before,.reading-box-container-4 .element-bottomshadow:after{opacity:0.70;}<\/style><div class=\"fusion-reading-box-container reading-box-container-4\" style=\"margin-top:0px;margin-bottom:10px;\"><div class=\"reading-box\" style=\"background-color:#f6f6f6;border-width:3px;border-color:#f6f6f6;border-left-width:3px;border-left-color:var(--primary_color);border-style:solid;\"><div class=\"reading-box-additional\">\n<h2>Possible Complications<\/h2>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-text fusion-text-5\"><p style=\"text-align: left;\" align=\"JUSTIFY\">In up to 40% of patients with AS, AS can also manifest in body parts which do not make up the joints (extra articular), such as the eye (ureitis) and heart. Other possible complications of AS include:<\/p>\n<ul>\n<li>Osteoporosis<\/li>\n<li>Spinal fractures (commonly at the thoracolumbar and cervicothoracic junctions, can occur minimal trauma)<\/li>\n<li>Cardiovascular diseases<\/li>\n<li>Chest infections<\/li>\n<li>Inflammatory bowel disease<\/li>\n<li>Neurological involvement<\/li>\n<li>Kidney disease (rarely)<\/li>\n<\/ul>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-4 fusion_builder_column_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"margin-top:0px;margin-bottom:30px;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><style type='text\/css'>.reading-box-container-5 .element-bottomshadow:before,.reading-box-container-5 .element-bottomshadow:after{opacity:0.70;}<\/style><div class=\"fusion-reading-box-container reading-box-container-5\" style=\"margin-top:0px;margin-bottom:10px;\"><div class=\"reading-box\" style=\"background-color:#f6f6f6;border-width:3px;border-color:#f6f6f6;border-left-width:3px;border-left-color:var(--primary_color);border-style:solid;\"><div class=\"reading-box-additional\">\n<h2>Assessment and Tests<\/h2>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-text fusion-text-6\"><p style=\"text-align: left;\" align=\"JUSTIFY\">If you have persistent symptoms of AS, you should make an appointment with your primary healthcare provider. Given that AS can present as a mechanical issue, chiropractors are trained to differentiate if a condition is mechanical or pathological in nature. This is done by taking a detailed history of your complaint before performing suitable tests during the physical examination. Further testing such as a blood test to detect the HLA-B27 gene, and imaging such as X-ray and MRI to visualise changes in the SI joints and\/or spine may also be warranted.<\/p>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-5 fusion_builder_column_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"margin-top:0px;margin-bottom:30px;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><style type='text\/css'>.reading-box-container-6 .element-bottomshadow:before,.reading-box-container-6 .element-bottomshadow:after{opacity:0.70;}<\/style><div class=\"fusion-reading-box-container reading-box-container-6\" style=\"margin-top:0px;margin-bottom:10px;\"><div class=\"reading-box\" style=\"background-color:#f6f6f6;border-width:3px;border-color:#f6f6f6;border-left-width:3px;border-left-color:var(--primary_color);border-style:solid;\"><div class=\"reading-box-additional\">\n<h2>Pain Management<\/h2>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-text fusion-text-7\"><p style=\"text-align: left;\" align=\"JUSTIFY\">Currently, there is no cure for AS. An early and timely referral to a specialist is a must to confirm the diagnosis so that treatment can begin as soon as possible. Medication may be prescribed to manage pain and inflammation. In rare cases, surgery may be required to replace a severely damaged joint, or to correct a badly bent back. Once any extra articular manifestations of the disease have been treated and\/or is being accounted for, a chiropractor and\/or physiotherapist can aid in the co-management of the AS patient. The aim of conservative treatment is to reduce the symptoms and possibly, slow down the progression of the disease. This is achieved by a combination of exercise therapy, and manual therapy that includes spinal manipulative therapy, myofascial therapy and mobilisation techniques. Therapeutic ultrasound, laser and interferential therapy may also be used to help with pain management.<\/p>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-6 fusion_builder_column_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"margin-top:0px;margin-bottom:30px;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><style type=\"text\/css\"><\/style><div class=\"fusion-title title fusion-title-1 fusion-title-text fusion-title-size-three\" style=\"margin-top:0px;margin-right:0px;margin-bottom:31px;margin-left:0px;\"><h3 class=\"title-heading-left fusion-responsive-typography-calculated\" style=\"margin:0;--fontSize:24;--minFontSize:24px;line-height:1.25;\"><h3>Reference<\/h3><\/h3><span class=\"awb-title-spacer\"><\/span><div class=\"title-sep-container\"><div class=\"title-sep sep-single sep-solid\" style=\"border-color:#e0dede;\"><\/div><\/div><\/div><div class=\"fusion-text fusion-text-8\"><ol>\n<li>Blausen.com staff, 2014. Medical gallery of Blausen medical 2014. WikiJournal of Medicine 1 (2). DOI:10.15347\/wjm\/2014.010. ISSN 2002-4436.<br \/>\nMcVeigh, CM., Cairns, AP., 2006. Diagnosis and management of ankylosing spondylitis. BMJ 2006; 333: 581-5.<\/li>\n<li>NHS, 2019. Ankylosing spondylitis [online]. London: NHS. Available from: https:\/\/www.nhs.uk\/conditions\/ankylosing-spondylitis\/ [Accessed August 2022].<\/li>\n<li>Souza, TA., 2016. Differential diagnosis and management for the chiropractor: protocols and algorithms. 5th edition. Burlington, Massachusetts, USA: Jones and Bartlett.<\/li>\n<\/ol>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":7,"featured_media":3107,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[129],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Ankylosing Spondylitis | HKerDr | Hong Kong Chiropractic Notes<\/title>\n<meta name=\"description\" content=\"\u5f37\u76f4\u6027\u810a\u690e\u708e (\u82f1\u6587: ankylosing spondylitis) 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