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Assessment and treatment of ankylosing spondylitis in adults

Author
David T Yu, MD
Section Editor
Joachim Sieper, MD
Deputy Editor
Paul L Romain, MD

INTRODUCTION

Ankylosing spondylitis (AS) is a chronic inflammatory disease manifested by back pain and progressive spinal stiffness. It belongs to the axial group of the spondyloarthritis (SpA) family. The two major members of this group are AS and non-radiographic axial SpA (nr-axSpA). The two differ in that significant plain radiographic changes affecting the sacroiliac joints are observed in patients with AS but not in those with nr-axSpA. AS characteristically affects young adults with a peak age of onset between 20 and 30 years. Although classically thought of as a spinal disease, transient acute arthritis of peripheral joints occurs in up to 50 percent of patients. In addition, other organs such as the eyes, lungs, heart, and kidneys can be affected.

The assessment, monitoring, prognosis, and treatment of ankylosing spondylitis in adults are presented here. The clinical manifestations and diagnosis of ankylosing spondylitis in adults, and a detailed discussion of the clinical manifestations, approach to diagnosis, pathogenesis, and treatment of SpA in children, are presented separately. (See "Clinical manifestations of ankylosing spondylitis in adults" and "Diagnosis and differential diagnosis of ankylosing spondylitis and non-radiographic axial spondyloarthritis in adults" and "Pathogenesis of spondyloarthritis" and "Spondyloarthropathy in children".)

GOALS OF MANAGEMENT

The primary goal of management for patients with ankylosing spondylitis (AS) is to maximize long-term health-related quality of life through the following:

Relief of symptoms – To eliminate symptoms such as pain, stiffness, and fatigue or to reduce them to the minimal possible level

Maintenance of function – To maintain the best possible functional capacity

                                              

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Literature review current through: Nov 2016. | This topic last updated: Thu Apr 21 00:00:00 GMT+00:00 2016.
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