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Ankylosing spondylitis (AS) (ANK-ki-low-sing spon-di-LIE-tis) is a chronic inflammatory disease that primarily affects the sacroiliac joints (where the spine attaches to the pelvis), spine, and hip joints. Ankylosing is a term meaning stiff or rigid and spondylitis means inflammation of the spine.
Enthesitis (inflammation of the place where ligaments and muscles attach to bones) accounts for much of the pain and stiffness of AS. This inflammation eventually can lead to bony fusion of the joints (where the fibrous ligaments transform to bone, and the joint permanently grows together).
Other joints can also develop synovitis (inflammation of the lining of the joint), with lower limb joints more commonly involved than upper-limb joints.
AS is one of a family of arthritis-related diseases called the seronegative spondylarthropathies. Seronegative means people with the disease test negative for the antibody rheumatoid factor and spondylarthropathy means joint disease of the spine. Ankylosing spondylitis most often develops in young adult men and it lasts a lifetime.
Early diagnosis and proper treatment can help control the pain and stiffness associated with AS, and may reduce or prevent deformity. Daily exercise of the affected joints is the most important treatment for AS. Medications that relieve pain and inflammation (usually nonsteroidal anti-inflammatory drugs) will allow you to get the exercise you need to maintain flexibility and mobility. Newer biologic agents such as tumor necrosis factor inhibitors can be very effective in patients who do not have significant relief with nonsteroidal anti-inflammatory drugs. Although these agents are very effective in the short term, it remains to be seen whether they can alter the progressive ankylosis (fusion of some or all spinal joints) of the disease in the long term.