Ankylosing spondylitis is a chronic disease of the spine and joints, leading to a fusion of the intervertebral spaces, as a result of which the spine completely loses mobility in all directions, becoming like a “bamboo shoot”. More often men are affected by this disease, ankylosing spondylitis in women occurs less frequently, in about 15% of cases (data about a 9: 1 ratio are outdated). The reason for this situation is that the disease in women is atypical and is later diagnosed.
What is ankylosing spondylitis?
This is a disease of the spine, joints and some internal organs that develops slowly, gradually. It almost always (but not in 100% of cases) occurs in people who have only one altered antigen in the immune system - HLA B27. The presence of just such an antigen leads to the fact that:
- joint tissue becomes more sensitive to infection;
- Some microbes, reacting with HLA B27, trigger the so-called autoimmune reaction when the body recognizes the tissue of its own joints as a foreign protein and begins to attack it.
As a result, inflammation occurs in the joints with destruction of the articular cartilage. First of all, the sacrum joins the pelvis, then the shock-absorbing layers between the vertebrae are destroyed.
The body tries to compensate for the deformation of the articular surfaces, but, unfortunately, the articular cartilage and intervertebral discs are not restored. As a result, bone tissue grows , and the ligamentous apparatus also ossifies in the spine.
In addition to joints, eyes (inflammation develops in them), kidneys, lungs and large vessels.
Features of the course in women
1. Ankylosing spondylitis in women proceeds according to the so-called rhizomyelic variant. This means that the spine and joints such as the shoulder and hip are affected.
2. Ankylosing spondylitis in women develops longer, with periods of exacerbations and remissions. Characteristic signs on the radiograph can be found only after 10-15 years from the onset of the disease.
3. Another feature is that in women, not the entire spine is ossified, but mainly only its lumbosacral spine. Ankylosing spondylitis in women is not so immobilized, as a result of which they retain minimal mobility even at the very last stages of the disease. In addition, their spine (unlike the male) is less deformed.
4. The internal organs are almost never involved in the process.
Ankylosing spondylitis in women begins with the appearance of pain in various joints, which are not very pronounced and do not particularly limit mobility. Then you can note back pain that occurs closer to the morning, sometimes a woman wakes up because of it. The pain goes away during the day. When probing the spine, only a slight pain in the sacral region is noted.
In some cases, one or both of the hip joints may be the first to suffer , in which the pain also appears in the early morning hours and extends to the groin and knee (less often reaches the heel). In the morning it is difficult to straighten the leg (s) in these joints, but the symptoms disappear during the day. Similar symptoms can occur in the shoulder joints, but they are not very pronounced, quickly (in the first hours) pass after a drunk pain pill, they can disappear for a while, then reappear with the same intensity.
Treatment of ankylosing spondylitis
“Female” treatment is no different from standard therapy. The only difficulty is to correctly diagnose.
1) Anti-inflammatory drugs "Olfen", "Butadion".
2) In rare cases, intra-articular administration of hormones (Kenalog, Diprospan) is necessary to relieve inflammation.
3) The drug "Sulfasalazine".
4) Immunosuppressants (Leukeran, Imuran drugs) can be used if the disease does not respond to standard therapy.
It is important to know that with ankylosing spondylitis it is important to maintain motor activity so that it progresses less.