It belongs to a group of diseases known as spondyloarthritis. It targets predominantly young males .The disease is more severe in males as compared to females. These disorders usually run in families. The main symptom is low back /neck pain with prolonged morning stiffness. Buttock pains, hip pain, difficulty in rolling sideways on bed are few of the other presenting symptoms. They can also have heel pain, pains in joints of upper and lower limbs. Apart from joint involvement it also present as pain, redness of eyes termed as uveitis medically. These can have skin lesions of psoriasis, recurrent diarrhoea etc. Early diagnosis and prompt initiation of treatment prevents irreversible bamboo spine formation which is a dreaded combination. The course is variable with spontaneous remissions and relapses.
In early stages the diagnosis depends mainly on presenting features, clinical examination by rheumatologist and a positive family history. In 70%, ESR/CRP is elevated. A definitive diagnosis can be made by imaging. HLA B27 is usually positive in these patients.
Early diagnosis, supervised treatment and physical therapy are essential for good outcome. NSAIDs are the main stay of treatment but are associated with potential adverse effects when used for prolonged period. Role of systemic steroids in this disease lacks scientific evidence. Recently newer drugs like biologics are available for treatment to improve functional outcome in those with severe disease. Surgical interventions like joint replacements, osteotomy are options in patients with severe limitation of movements, disabling pain, deformities. physiotherapy plays an important role in these patients by imporving mobility and prevents deformities. Their by imprving quality of life.