Ankylosing spondylitis natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Ankylosing spondylitis can range from mild to progressively debilitating. In a long-term undiagnosed period, osteopenia or osteoporosis of AP spine may occur, causing eventual compression fractures and a back "hump" if untreated. Due to the fusion of the vertrbrae, paresthesia may develop. Other complications are Aortic regurgitation, Achilles tendinitis, AV node block, Amyloidosis and lung fibrosis.
Natural History
Complications
Prognosis
AS can range from mild to progressively debilitating, and from medically controlled to refractive.
Unattended cases of AS normally lead to knee pain, and may be accompanied by dactylitis or enthesitis, which may result in a misdiagnosis of normal rheumatism. In a long-term undiagnosed period, osteopenia or osteoporosis of AP spine may occur, causing eventual compression fractures and a back "hump" if untreated. Typical signs of progressed AS are the visible formation of syndesmophytes on X-rays, an abnormal bone outgrowth similar to osteophytes, affecting the spine. Due to the fusion of the vertrbrae paresthesia is a complication due to the inflammation of the tissue surrounding nerves.
Organs affected by AS, other than the axial spine and other joints, are commonly the heart, lungs, colon, and kidney. Other complications are Aortic regurgitation, Achilles tendinitis, AV node block and Amyloidosis. Due to lung fibrosis, chest X-rays may show apical fibrosis while pulmonary function testing may reveal a restrictive lung defect. Very rare complications involve neurologic conditions such as the cauda equina syndrome.[1]
References
- ↑ Nicholas U. Ahn, Uri M. Ahn, Elizabeth S. Garrett; et al. (2001). "Cauda Equina Syndrome in AS (The CES-AS Syndrome): Meta-analysis of outcomes after medical and surgical treatments". J of Spinal Disorders. 14 (5): 427–433. PMID 11586143.