· A chronic, systemic inflammatory rheumatic disorder with the predilection for inflammation at sites where the tendons and ligaments attach to the bones (enthesitis), especially in the sacroiliac joints and the spinal column.

· The symptoms usually start during late teens or early twenties (rarely after age 45), and is 2 to 3 times more common in males. The most common presenting symptoms is chronic back pain and stiffness resulting from inflammation affecting the sacroiliac joints (sacroilitis) and spine (spondylitis).

. There is generally good symptomatic relief from back pain with adequate (anti-inflammatory) dose of non steroidal anti-inflammatory drugs (NSAIDs), such as naprosyn, ibuprofen and diclofenac.

. The other clinical features of AS and related SpA may include asymmetric arthritis (that more often affects lower extremities) orinflammation of some of the extra-articular structures such as the eye (iritis), the skin (psoriasis) and the gut (Crohn's disease and ulcerative colitis). 

. The presenting clinical manifestations of these diseases can be very wide-ranging, and thus a variety of health care professionals (from primary care physicians, ophthalmologists and dermatologists to rheumatologists and other medical and surgical specialists) see such patients.

. Unfortunately, most patients with AS are either diagnosed late or are inadequately treated (and some are never diagnosed). The current mean delay in the diagnosis of AS ranges from 5 to 10 years.

. Earlier diagnosis and treatment can better mitigate the severity of the disease, and make a meaningful difference for patient care and quality of life.

. With the availability of newer, highly effective treatments (with TNF-blockers, such as Enbrel, Humira, Remicade), and better methods of musculoskeletal imaging (such as MRI), there is an urgent need to improve early diagnosis and reduce any inappropriate delay in obtaining effective treatment.



Excerpted from:

• Ankylosing Spondylitis: the Facts
• Ankylosing Spondylitis