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Australian Family Physician Nov 2013Ankylosing spondylitis (AS) affects one in 200 individuals and is usually diagnosed many years after onset of symptoms. Chronic back pain is common and recognition of... (Review)
Review
BACKGROUND
Ankylosing spondylitis (AS) affects one in 200 individuals and is usually diagnosed many years after onset of symptoms. Chronic back pain is common and recognition of early disease requires clinical experience and a high index of suspicion. Further, inflammatory markers are not invariably elevated and radiographic changes are often late findings.
OBJECTIVE
The objective of this review is to address AS and the recently defined disorder of non-radiographic axial spondyloarthritis. The latter is a common early presentation of AS, before the development of radiographic sacroiliitis, and will evolve into typical AS in 50% of patients.
DISCUSSION
MRI may be particularly useful in evaluating early disease, although chronic changes of sacroiliitis are better seen on plain X-rays. Nonsteroidal anti-inflammatory drugs (NSAIDs) are first-line therapy and recent studies suggest that regular use among patients with AS slows radiographic progression. Tumour necrosis inhibitor therapy has strikingly improved quality of life for the more than two-thirds of AS patients with an inadequate response to NSAIDs.
Topics: Anti-Inflammatory Agents, Non-Steroidal; Biomarkers; Disease Progression; Humans; Magnetic Resonance Imaging; Spondylitis, Ankylosing
PubMed: 24217097
DOI: No ID Found -
Journal of Anatomy Dec 2012This article focuses on the (functional) anatomy and biomechanics of the pelvic girdle and specifically the sacroiliac joints (SIJs). The SIJs are essential for... (Review)
Review
This article focuses on the (functional) anatomy and biomechanics of the pelvic girdle and specifically the sacroiliac joints (SIJs). The SIJs are essential for effective load transfer between the spine and legs. The sacrum, pelvis and spine, and the connections to the arms, legs and head, are functionally interrelated through muscular, fascial and ligamentous interconnections. A historical overview is presented on pelvic and especially SIJ research, followed by a general functional anatomical overview of the pelvis. In specific sections, the development and maturation of the SIJ is discussed, and a description of the bony anatomy and sexual morphism of the pelvis and SIJ is debated. The literature on the SIJ ligaments and innervation is discussed, followed by a section on the pathology of the SIJ. Pelvic movement studies are investigated and biomechanical models for SIJ stability analyzed, including examples of insufficient versus excessive sacroiliac force closure.
Topics: Ankylosis; Biological Evolution; Female; Humans; Ligaments; Male; Models, Biological; Movement; Pelvis; Sacroiliac Joint; Sex Characteristics
PubMed: 22994881
DOI: 10.1111/j.1469-7580.2012.01564.x -
Frontiers in Immunology 2019
Topics: Disease Management; Disease Susceptibility; Humans; Immune System Diseases; Spondylitis, Ankylosing
PubMed: 31214188
DOI: 10.3389/fimmu.2019.01232 -
Rheumatology (Oxford, England) Mar 2019In ankylosing spondylitis (AS), structural damage that occurs as a result of syndesmophyte formation and ankylosis of the vertebral column is irreversible. Structural... (Review)
Review
In ankylosing spondylitis (AS), structural damage that occurs as a result of syndesmophyte formation and ankylosis of the vertebral column is irreversible. Structural damage is currently assessed by conventional radiography and scoring systems that reliably assess radiographic structural damage are needed to capture the differential effects of drugs on structural damage progression. The validity of the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) as a primary outcome measure in evaluating the effect of AS treatments on radiographic progression rates was assessed in this review. The mSASSS has not been used, to date, as a primary outcome measure in a prospective randomized controlled clinical trial of biologic therapy in AS. This review of the medical literature confirmed that the mSASSS is the most validated and widely used method for assessing radiographic progression in AS, correlating with worsening measures of disease signs and symptoms, spinal mobility and physical function, with a 2-year interval being required to ensure sufficient sensitivity to change.
Topics: Anti-Inflammatory Agents; Disease Progression; Humans; Radiography; Severity of Illness Index; Spondylitis, Ankylosing
PubMed: 29860356
DOI: 10.1093/rheumatology/key128 -
Medicine Apr 2016Ankylosing spondylitis (AS) is a common and genetically heterozygous inflammatory rheumatic disease characterized by new bone formation, ankylosis and inflammation of... (Review)
Review
Ankylosing spondylitis (AS) is a common and genetically heterozygous inflammatory rheumatic disease characterized by new bone formation, ankylosis and inflammation of hip, sacroiliac joints and spine. Until now, there is no method for early diagnosis of AS and the effective treatment available for AS patients remain largely undefined.We searched articles indexed in PubMed (MEDLINE) database using Medical Subject Heading (MeSH) or Title/Abstract words ("microRNA" and "ankylosing spondylitis") from inception up to November 2015.Genetic polymorphisms of miRNAs and their targets might alter the risk of AS development whereas certain miRNAs exhibit correlation with inflammatory index.Let-7i and miR-124 were upregulated whereas miR-130a was downregulated in circulating immune cells of AS patients. These deregulated miRNAs could modulate key immune cell functions, such as cytokine response and T-cell survival.miRNA deregulation is key to AS pathogenesis. However, clinical utilization of miRNAs for management of AS patients requires further support from future translational studies.
Topics: Humans; MicroRNAs; Spondylitis, Ankylosing
PubMed: 27057910
DOI: 10.1097/MD.0000000000003325 -
International Journal of Nanomedicine 2019Ankylosing spondylitis (AS) is a complex disease characterized by inflammation and ankylosis primarily at the cartilage-bone interface. The disease is more common in... (Review)
Review
Ankylosing spondylitis (AS) is a complex disease characterized by inflammation and ankylosis primarily at the cartilage-bone interface. The disease is more common in young males and risk factors include both genetic and environmental. While the pathogenesis of AS is not completely understood, it is thought to be an immune-mediated disease involving inflammatory cellular infiltrates, and human leukocyte antigen-B27. Currently, there is no specific diagnostic technique available for this disease; therefore conventional diagnostic approaches such as clinical symptoms, laboratory tests and imaging techniques are used. There are various review papers that have been published on conventional treatment approaches, and in this review work, we focus on the more promising nanomedicine-based treatment modalities to move this field forward.
Topics: Analgesics; Animals; Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Antibodies, Monoclonal; Female; Humans; Hydrogels; Liposomes; Male; Nanomedicine; Nanoparticles; Physical Therapy Modalities; Spondylitis, Ankylosing; Tumor Necrosis Factor-alpha
PubMed: 31806960
DOI: 10.2147/IJN.S216199 -
The American Journal of Pathology May 2022Pathologic soft tissue calcification can occur in both genetic and acquired clinical conditions, causing significant morbidity and mortality. Although the... (Review)
Review
Pathologic soft tissue calcification can occur in both genetic and acquired clinical conditions, causing significant morbidity and mortality. Although the pathomechanisms of pathologic calcification are poorly understood, major progress has been made in recent years in defining the underlying genetic defects in Mendelian disorders of ectopic calcification. This review presents an overview of the pathophysiology of five monogenic disorders of pathologic calcification: pseudoxanthoma elasticum, generalized arterial calcification of infancy, arterial calcification due to deficiency of CD73, ankylosis, and progeria. These hereditary disorders, caused by mutations in genes encoding ATP binding cassette subfamily C member 6, ectonucleotide pyrophosphatase/phosphodiesterase 1, CD73, progressive ankylosis protein, and lamin A/C proteins, respectively, are inorganic pyrophosphate (PPi) deficiency syndromes with reduced circulating levels of PPi, the principal physiologic inhibitor of calcium hydroxyapatite deposition in soft connective tissues. In addition to genetic diseases, PPi deficiency has been encountered in acquired clinical conditions accompanied by pathologic calcification. Because specific and effective treatments are lacking for pathologic calcification, the unifying finding of PPi deficiency suggests that PPi-targeted therapies may be beneficial to counteract pathologic soft tissue calcification in both genetic and acquired diseases.
Topics: Ankylosis; Calcinosis; Choristoma; Diphosphates; Humans; Pseudoxanthoma Elasticum; Syndrome; Vascular Calcification
PubMed: 35182493
DOI: 10.1016/j.ajpath.2022.01.012 -
Missouri Medicine 2022Understanding of the spondyloarthritis diseases has changed significantly in the last 15 years. It is now clear that there are patients with and without radiographic...
Understanding of the spondyloarthritis diseases has changed significantly in the last 15 years. It is now clear that there are patients with and without radiographic changes and the terminology has changed to reflect that: radiographic axial spondyloarthritis and non-radiographic axial spondyloarthritis. In addition, the importance of the presence of inflammatory back pain with spondyloarthritis in making the diagnosis is now well established. It is also clear that women are much more likely to develop axial spondyloarthritis than previously thought. Finally, there are treatments now available to treat axial spondyloarthritis and more hopefully to be approved in the next year.
Topics: Axial Spondyloarthritis; Female; Humans; Pain; Spondylarthritis; Spondylitis, Ankylosing
PubMed: 36033135
DOI: No ID Found -
The Chinese Journal of Dental Research 2012Trauma is the predominant causal factor for temporomandibular joint (TMJ) ankylosis. However, the relationship between condylar fracture and TMJ ankylosis is... (Review)
Review
Trauma is the predominant causal factor for temporomandibular joint (TMJ) ankylosis. However, the relationship between condylar fracture and TMJ ankylosis is complicated. It is believed that post-traumatic TMJ ankylosis arises from TMJ intracapsular changes, including damaged cartilage, displaced or disrupted discs, haematoma formation and subsequent fibrosis and calcification in the joint. In this review, the relationship between TMJ ankylosis and condylar fracture is discussed based on clinical characteristics and animal studies. The management of TMJ ankylosis is also reviewed and discussed.
Topics: Animals; Ankylosis; Disease Models, Animal; Humans; Mandibular Condyle; Mandibular Fractures; Temporomandibular Joint Disorders
PubMed: 22866277
DOI: No ID Found -
Mayo Clinic Proceedings Jan 2022Axial spondyloarthritis (axSpA) is a chronic, immune-mediated inflammatory disease characterized by inflammatory low back pain, inflammation in peripheral joints and... (Review)
Review
Axial spondyloarthritis (axSpA) is a chronic, immune-mediated inflammatory disease characterized by inflammatory low back pain, inflammation in peripheral joints and entheses, and other extra-articular or systemic manifestations. Although our understanding of the natural history of axSpA has been limited by incomplete knowledge of disease pathogenesis, axSpA is increasingly understood as a spectrum of axial, peripheral, and extra-articular inflammatory conditions that includes nonradiographic axSpA and radiographic axSpA, also known as ankylosing spondylitis. In this narrative review, we present a road map of this axSpA continuum, highlighting genetic risk factors for the development of axSpA, triggers of disease, and reasons for and implications of diagnostic delay. We present a detailed overview of the spectrum of axSpA clinical manifestations and highlight factors known to influence the risk of disease progression. Finally, we provide some expert commentary on the practical use of this road map to assist health care providers in the identification of axSpA in clinical practice.
Topics: Delayed Diagnosis; Disease Progression; Female; Humans; Male; Non-Radiographic Axial Spondyloarthritis; Risk Factors; Spondylitis, Ankylosing
PubMed: 34801248
DOI: 10.1016/j.mayocp.2021.08.007