Xiao Wang is a young white-collar worker in a company. Recently, I don’t know why he always feels pain in his back and waist when he sleeps and turns over at night. When he wants to get up in the morning, he feels extremely stiff in his back and shoulders and needs to change his posture and have a rest. At ordinary times, I take the subway to work, and I always feel numbness and pain in my lower limbs after standing for a long time.
Xiao Wang thought that some elders in his family suffered from lumbar muscle strain and similar symptoms, so he applied plasters according to the gourd and gourd ladle.
I also heard people around me say it might be [lumbar disc herniation]. Xiao Wang didn’t care at that time, but after a long time, the symptoms didn’t improve and obvious pain began to appear in his buttocks.
In order to find out whether it was what’s problem, Xiao Wang came to the orthopaedic department of the hospital. The doctor told Xiao Wang that according to his age and condition, ankylosing spondylitis needs to be excluded, and gave Xiao Wang targeted examinations such as sacroiliac joint CT scan and serum HLA-B27 test, and suggested to go to the rheumatology and immunology department for further treatment.
Is ankylosing spondylitis common?
As an autoimmune disease, ankylosing spondylitis is probably second only to rheumatoid arthritis and systemic lupus erythematosus.
Celebrity patients, such as Jay Chou and mainland actor Zhang Jiayi, have also greatly increased the popularity of the disease. Ostrovsky, author of the well-known “Steel Made in how”, is also a patient with ankylosing spondylitis.
Ankylosing spondylitis is not a rare disease. About 1-3 patients suffer from ankylosing spondylitis in every 1,000 people. Moreover, the disease especially favors young men.
In fact, most patients with ankylosing spondylitis are men under 40 years old, with 20-30 years old as the peak of onset. Most of the celebrities mentioned above also started onset at this age.
Ankylosing spondylitis that is easily neglected
Ankylosing spondylitis is a very [low-key] disease, especially good at disguise.
1. Early symptoms are atypical and easy to be misdiagnosed.
In the early stage of the disease, the main symptoms are waist and back or hip pain. When getting up in the morning or standing up after sitting for a long time, the waist and back feel stiff, and sometimes there are chest pain, neck pain, shoulder pain and foot pain. In addition to joint muscle symptoms, some patients may also have iritis symptoms such as vision loss or gastrointestinal symptoms such as abdominal pain and diarrhea.
However, these symptoms are not specific. If doctors and patients do not pay attention to them, they will easily be misdiagnosed as lumbar muscle strain, osteoarthritis and other diseases.
2. Serious influence on joint function in late stage
As an autoimmune disease, patients’ joints are often attacked by the autoimmune system after onset.
If there is no targeted treatment, but only pay attention to rest or general treatment like lumbar muscle strain, the disease will still develop.
Arthritis develops to the end, which will lead to complete necrosis and fusion of joints, loss of function, and patients may even be unable to walk.
Clinicians do see such patients: after passing through many hospitals, they have not been diagnosed and have not received timely and standardized treatment, which eventually leads to disease progression, joint fusion of diseased diseases and development into disability. It is a pity.
How to discover ankylosing spondylitis as soon as possible?
Therefore, for young people, if there are the following situations, should be paid attention to, as soon as possible to see a doctor:
- Long-term low back pain and stiffness cannot be relieved after rest. Unilateral or bilateral sciatica, bilateral hip and hip pain; Repeated swelling and pain of knee joint and ankle joint, heel pain and inconvenience of movement; Spinal back pain, stiffness, and even limited movement; Iritis, photophobia, dry eyes, vision loss and blurred vision; No respiratory symptoms such as cough, chest pain and limited thoracic movement.
A few days later, Xiao Wang’s examination results came out:
- Sacroiliac Joint CT: Suggests Sacroiliac Arthritis; HLA-B27 test of serum showed positive.
The doctor told Xiao Wang that imaging examination is very important for the early diagnosis of ankylosing spondylitis, and the serum HLA-B27 examination of patients with ankylosing spondylitis is also more likely to produce positive results than normal people. Combined with his symptoms, the diagnosis of ankylosing spondylitis can basically be confirmed.
How to treat ankylosing spondylitis?
STEP 1 Relieve Symptoms
The doctor prescribed Xiao Wang drugs such as Celecosi and sulfasalazine to control the symptoms, and told Xiao Wang that for most patients with ankylosing spondylitis, these treatments are sufficient to relieve the symptoms and control the disease.
After several weeks of treatment, Xiao Wang’s symptoms of low back pain and hip pain have obviously improved. When returning to the clinic, Xiao Wang expressed his gratitude to the doctor, but at the same time he was worried about whether the illness would repeat.
2. Control the development of the disease
The doctor further explained to Xiao Wang that ankylosing spondylitis is an autoimmune disease, and the current medical methods cannot cure ankylosing spondylitis.
For those patients who have undergone routine treatment and are not well controlled, treatment with relatively greater side effects such as glucocorticoids and immunosuppressants can also be considered. If economic conditions permit, patients can also consider using relatively expensive biological agents. However, Xiao Wang’s current condition is relatively stable, so such treatment is not needed for the time being.
However, it is still very important to follow up regularly and pay attention to the development of the disease and side effects of drugs. After listening to the doctor’s explanation and advice, Xiao Wang left the clinic with confidence.
Summary
Ankylosing spondylitis is more common in young men, and the early onset symptoms are not specific. It is extremely important to see a doctor as early as possible to improve imaging and HLA-B27 detection.
The treatment of ankylosing spondylitis mainly includes non-steroidal anti-inflammatory drugs and drugs to improve the condition of rheumatism. Hormones, immunosuppressants and biological agents can also be used for patients whose condition cannot be controlled.