DESCRIPTION

Espondilitis Anquilosante or Anquilopoyética (EA) is a rheumatic illness that produces inflammation of the joints of the spine and of the sacroilíacas. It can be evident like isolated waist pain episodes, or, in his most serious form, affect to the whole column and to the peripheral joints, causing pain in the column and in the joints, vertebral rigidity, loss of mobility and deformity to articulate progressive.

Sometimes he can accompany himself of declarations you will extraarticulate, like inflammation in the eyes or in the valves of the heart.

The EA belongs to a group of illnesses that they affect to the rachis, called Espondiloartropatías. In this group, in addition to the EA there is included the Syndrome of Reiter, some forms of Artropatía Psoriásica and the Artropatía associated with the Intestinal Inflammatory Illness.

WHAT IS HIS CAUSE?

The cause of Espondilitis Anquilosante is not known, but all the espondiloartropatías share a common genetic scoreboard, HLAB27, that appears in most of the fond individuals.

In some cases, the illness appears in these patients predisposed after exhibition to an intestinal infection or of the urinal tract.

I AFFECT THE POPULATION

It affects, approximately, 1 of every 1000 inhabitants. Typically it begins in the adolescence or in the youth, and his incidence is major in the men than in the women presenting these, also, a lighter illness. His incidence also changes in the different racial groups.

DIAGNOSIS

The base of the diagnosis of Espondilitis Anquilosante, there are the symptoms recounted by the patient and the alterations observed by the doctor in the physical exploration. Often the diagnosis is late because the symptoms of the illness assume to other more common processes, which they affect to the lumbar region. The night pain and the loss of mobility in the lumbar region, are precocious and common declarations of the EA. Although most of the cases, the symptoms begin in the areas lumbar and sacroilíaca, there usually fall ill also the cervical and back segments of the column. The arthritis also can affect to the big peripheral joints (shoulders and hips) and also big toe and heels. Some patients have ocular inflammation and, in the most serious cases, there can be observed affectation of the cardiac valves.

Sometimes, the espondilitis anquilosante can precede the development of an intestinal inflammatory illness and some patients present high fever, fatigue, loss of weight and anemia.

Other visceral or bony illnesses, they can imitate the Espondiloartropatías and must be distinguished from them: the analytical evaluation can demonstrate inflammation, anemia or positividad of the HLAB27. The radiographies and gammagrafías bony they can show typical changes.

TREATMENT

The gravity of the affectation to articulate and the grade of systemic declarations they change greatly from a few individuals to others. The precocious and precise diagnosis and the suitable treatment can minimize the pain and the functional incapability.

The medical treatment is based on the anti-inflammatory not esteroideos (AINEs). The Indometacina is the most effective of them. The Sulfasalacina can be beneficial in those patients with more serious illness. The arthritis of the peripheral joints can answer to Metotrexato.

The treatment reoutfitter is essential. The position adapted during the sleep and in the deambulación, together with exercises for the abdominal musculature and paravertebral, they help to prepare the deformities. There must be programmed exercises that support the flexibility to articulate and respiratory exercises to support the pulmonary capacity. Even, with an ideal treatment, some patients develop rigidity or anchylosis of the rachis.

Sometimes he can accompany himself of declarations you will extraarticulate, like inflammation in the eyes or in the valves of the heart.

A continued treatment is decisive.

Espondilitis Anquilosante is a chronic problem that persists along the whole life and some patients, often, leave the treatment with the deformities result posturales perms and loss of the mobility.

THE ROLE OF THE REUMATÓLOGO IN THE TREATMENT

The Reumatólogo has received a specific formation to diagnose and to treat the EA, can serve like patients' educator and also of other doctors on the above mentioned illness.

The Reumatólogos are in the head in the fundamental and clinical research on this illness, and on them a progress depends in the knowledge and the treatment of the same one.

WHAT DOCTOR CAN TREAT ME?

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