Ankylosing spondylitis (AS) is a rare inflammatory disorder that affects the axial skeleton. It is characterized by inflammation of the joints of the spine with subsequent bridging of the spinal segments resulting in ...Ankylosing spondylitis (AS) is a rare inflammatory disorder that affects the axial skeleton. It is characterized by inflammation of the joints of the spine with subsequent bridging of the spinal segments resulting in a reduced mobility of the spine and subsequent stiffness of the spine. It can be a severely limiting condition adversely affecting the quality of life of affected individuals. It has been found to be commoner in Caucasians and Asians but rare in blacks in the Americas with few cases reported amongst the African Black population. It is associated with the occurrence of the major histocompatibility complex (MHC) class 1 allele HLA-B27. We present the case of a 44-year-old Nigerian man presenting with a 21-year history of progressively worsening back pain and stiffness associated with hip pain and difficulty in extending his neck. He had no extraspinal manifestations. He was diagnosed with Ankylosing Spondylitis using the modified New York criteria. He was commenced on selective COX2 inhibitors and a physical therapy program aimed at improving the flexibility of the spine and reducing pain. He had a significant improvement in his pain and improved flexibility of his spine in all planes. Ankylosing spondylitis affects the axial skeleton primarily but there may be some extra spinal manifestations such as anterior uveitis, psoriasis and inflammatory bowel disease. Various modalities are employed in its treatment ranging from physical therapy, drugs e.g. Nonsteroidal anti-inflammatory drugs, tumour necrosis factor inbibitors and surgery where complications arise. These have proven effective in improving the symptoms of the disease and quality of life.展开更多
文摘Ankylosing spondylitis (AS) is a rare inflammatory disorder that affects the axial skeleton. It is characterized by inflammation of the joints of the spine with subsequent bridging of the spinal segments resulting in a reduced mobility of the spine and subsequent stiffness of the spine. It can be a severely limiting condition adversely affecting the quality of life of affected individuals. It has been found to be commoner in Caucasians and Asians but rare in blacks in the Americas with few cases reported amongst the African Black population. It is associated with the occurrence of the major histocompatibility complex (MHC) class 1 allele HLA-B27. We present the case of a 44-year-old Nigerian man presenting with a 21-year history of progressively worsening back pain and stiffness associated with hip pain and difficulty in extending his neck. He had no extraspinal manifestations. He was diagnosed with Ankylosing Spondylitis using the modified New York criteria. He was commenced on selective COX2 inhibitors and a physical therapy program aimed at improving the flexibility of the spine and reducing pain. He had a significant improvement in his pain and improved flexibility of his spine in all planes. Ankylosing spondylitis affects the axial skeleton primarily but there may be some extra spinal manifestations such as anterior uveitis, psoriasis and inflammatory bowel disease. Various modalities are employed in its treatment ranging from physical therapy, drugs e.g. Nonsteroidal anti-inflammatory drugs, tumour necrosis factor inbibitors and surgery where complications arise. These have proven effective in improving the symptoms of the disease and quality of life.
