| Ankylosing Spondylitis is one of the more
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| | goals consist of relieving pain and
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| common forms of arthritis affecting about
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| | stiffness as well as maintaining
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| 0.5% of the population. It affects men
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| | function.A comprehensive program consists
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| more often than women in a ratio of about
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| | of a combination of anti-inflammatory
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| 2.4-5:1. The disease is categorized as a
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| | medicines to help with symptoms as well
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| "spondyloarthropathy"... a type of
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| | as disease-modifying therapy to slow down
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| arthritis that preferentially affects the
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| | the rate of progression. Examples of
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| spine. It usually starts in the
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| | anti-inflammatory drugs are drugs such as
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| sacroiliac joints- the joints that join
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| | ibuprofen (Motrin), naproxen (Naprosys),
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| the pelvis to the low back- and spreads
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| | nabumetone (Relafen), etodolac (Lodine),
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| upwards to involve the rest of the spine.
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| | meloxicam (Mobic), and celecoxib
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| Peak age of onset is between 15 and 30
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| | (Celebrex). Disease-modifying drugs that
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| years.Typically, a patient will complain
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| | are used extensively for this condition
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| of stiffness in the low back or neck or
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| | are sulfasalazine (Azulfidine) and
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| both that is worse with rest and better
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| | methotrexate. Biologic therapies like
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| with activity. Often, a young person will
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| | etanercept (Enbrel), adalimumab
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| pursue sports as a way to relieve the
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| | (Humnira), and infliximab (Remcade) are
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| pain they have! Stiffness during the day
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| | considered important for inducing
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| after inactivity is also common. Other
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| | remission. A solid program of physical
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| joints affected include the hip, knee,
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| | therapy to help with range of motion is
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| wrists, shoulders, elbows, and ankles.
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| | also mandatory.For patients with
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| Fatigue is a very common symptom.
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| | suspected eye disease, close supervision
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| Occasionally low grade fever, appetite
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| | by an experienced ophthalmologist is also
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| loss, and weight loss may be
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| | recommended.Patients with far-advanced
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| seen.Patients will sometimes present with
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| | disease may suffer complications
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| the extra-articular (outside of the
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| | including compression of the spinal cord
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| joint) symptoms. Examples include
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| | (cauda equina syndrome), and fractures of
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| inflammation of the eye, lungs, and
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| | the neck. In particular, care should be
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| rarely, the heart. The most common
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| | exercised in preparing patients with AS
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| extra-articular symptom is eye
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| | for surgery. Intubation (placing a
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| inflammation which occurs in about 40% of
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| | breathing tube into the airways) for
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| patients and must be diagnosed and
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| | general anesthesia carries the risk of
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| treated aggressively. Blindness is a
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| | inadvertent spine fracture.Surgery is
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| dreaded complication.The physical exam
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| | reserved for far advanced cases that have
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| will show limitation of range of motion
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| | not responded to medical therapy.The
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| in the low back. Chest expansion is also
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| | clinical course and prognosis is highly
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| restricted since many patients with AS
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| | variable and also highly dependent on the
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| will have limited ability to expand their
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| | rapidity of diagnosis and the
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| lungs due to involvement of the thoracic
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| | effectiveness of therapy.Dr. Wei
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| spine.Occasionally, women with AS will
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| | (pronounced "way") is a board-certified
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| have more symptoms in the neck than the
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| | rheumatologist and Clinical Director of
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| low back.Laboratory testing will show
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| | the nationally respected Arthritis and
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| abnormalities that indicate the presence
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| | Osteoporosis Center of Maryland. He is a
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| of inflammation. Patients with AS will
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| | Clinical Assistant Professor of Medicine
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| also have the genetic marker HLA B27 in
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| | at the University of Maryland School of
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| about 90% of cases.Imaging studies such
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| | Medicine and has served as a consultant
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| as magnetic resonance imaging will show
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| | to the Arthritis Branch of the National
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| the presence of inflammation in the
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| | Institutes of Health. He is a Fellow of
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| sacroiliac joints. Inflammation of the
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| | the American College of Rheumatology and
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| tendon insertions at different affected
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| | the American College of Physicians.
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| joints will also be evident.Treatment
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