This is an automatically translated article.
The article is professionally consulted by Master, Doctor Nguyen Van Phan - Department of Diagnostic Imaging and Nuclear Medicine - Vinmec Times City International General Hospital
Doctors need to combine both clinical examination, imaging and biochemical tests before making a final conclusion to diagnose ankylosing spondylitis.
1. What is ankylosing spondylitis?
Ankylosing spondylitis is characterized by damage to the sacroiliac joints, the spine (called axial joints), and sometimes can also affect peripheral joints (eg, the knee, the feet, hands...) and even the whole body, this is a chronic systemic inflammatory disease.
Because the signs of back pain can be related to many other health problems, the disease is often difficult to detect early, so it can cause ankylosing as well as vertebrae to occur, which can lead to life a series of complications such as:
Back hunchback. Ankylosing spondylitis of the hip. Osteoporosis . Disabled. Therefore, you need to quickly see a reputable rheumatologist if you have back pain for more than 3 months, the intensity of the pain tends to increase when you rest and when you exercise, the pain goes away.
Viêm cột sống dính khớp được đặc trưng bởi những tổn thương ở khớp cùng chậu, cột sống (được gọi là các khớp trục)
2. Causes and pathogenesis
Currently, the cause of ankylosing spondylitis is still unknown, but studies show that the disease may be related to genetic factors. According to some studies, the rate of co-morbidity is 63% in identical twins, and 13% in fraternal twins. Your chances of developing ankylosing spondylitis increase by 6-16 times if a close family member (parent, sibling, child) has the disease.
Studies have found many genes related to VCSDK, in which HLA-B27 is a "genetic marker" for human leukocyte antigen regulation that has been shown to be involved in the pathogenesis of HLA -B27 occurs in about 90% of patients with ACS. This HLA-B27 is a protein found in >95% of patients with Caucasian ACS, is seen in most Caucasians, and is more commonly associated with intestinal disease, but it should be remembered that the substance is not necessarily present. Only at this point do people get VCSDK just as most people with HLA-B27 never get VCSDK.
Scientists also suspect that a number of other markers along with environmental factors (eg bacterial infection) play a role in VCSDK activation, such as HLA-B60, HLA-DR1.
3. Diagnosis of ankylosing spondylitis
Various tests must be performed during the diagnosis of ankylosing spondylitis to look for signs and symptoms characteristic of the disease, and at the same time rule out the possibility that other joint diseases are present.
For the majority of cases, the diagnostic process will be started by the doctor asking questions about the patient's clinical condition, such as:
In addition to persistent back pain, Do you have any other unusual symptoms? How long have your symptoms been around? Have you tried any treatments and have they worked? Do you have an underlying medical condition? Your medical history. Are your family members experiencing these symptoms? Next, to look for clinical signs of ankylosing spondylitis, specialists will conduct a general physical examination. Your doctor may order you to perform a few simple exercises to check which joints have inflammation, joint range of motion.
In addition, to diagnose this arthritis, your doctor needs to assign you to perform a number of steps after a physical examination, including:
Diagnostic imaging: One of the typical imaging features is easy to recognize. of ankylosing spondylitis is damage to the sacroiliac joint. Therefore, the patient will be prescribed by the doctor to check the sacroiliac joint first if back pain is more than 3 months. Based on the results of the X-ray, your doctor may find signs of sacroiliitis. However, often this method is only applied effectively for cases of back pain, arthritis that has lasted for many years. Therefore, experts will choose methods that can provide more detailed and accurate images of ankylosing spondylitis in the early stages, such as:
MRI scan of sacroiliac joints and spine: In ankylosing spondylitis, this is the method that helps detect damage on joints at the earliest. To diagnose the disease, this is also the method used in clinical practice. CT scan of the sacroiliac joint and spine. Ultrasound of the sacroiliac joint. Blood tests: You may also need a few more blood tests in addition to the imaging tests for the purposes of:
Rule out other health problems. Confirm the diagnosis of ankylosing spondylitis. The doctor also orders some tests other than a complete blood count (CBC), such as:
PCR test and erythrocyte sedimentation rate (ESR) test : Look for synthesized C-reactive proteins in the liver when the body is inflamed is the target of PCR testing. However, when blood PCR levels are high because there are many agents capable of triggering an inflammatory response, doctors still cannot conclude that a person has ankylosing spondylitis. When the body is inflamed, the erythrocyte sedimentation rate (ESR) usually increases. Besides, to assess general health and prescribe appropriate medicine for each patient, doctors also order some general tests such as total blood cell analysis, liver and kidney function. Testing for genetic factors HLA-B27: The percentage of people with ankylosing spondylitis who have HLA-B27 genetic factors ranges from 85-95%. Therefore, your doctor will run a test to look for HLA-B27 if he suspects you have this type of arthritis. In practice, however, in some cases, you may not need this test. When you visit the doctor, the musculoskeletal doctor will give more specific advice.
Trong bệnh lý viêm cột sống dính khớp, MRI chính phương pháp giúp phát hiện tổn thương trên khớp sớm nhất.=
4. Treatment of ankylosing spondylitis
Although ankylosing spondylitis can make you hunchback, disabled and affect your heart or lungs, you do not need to be too worried if you are diagnosed with this disease because if it is treated early and effectively In the first place, you can completely prevent these dangerous complications.
Here are a few things you need to pay attention to during the treatment process, including:
Well control the symptoms of the disease and limit the progression of the disease by using the right medicine according to the treatment regimen. After running out of medicine, do not arbitrarily buy old prescription drugs. Your doctor will decide if your old prescription needs to be changed after examining a number of factors such as the number of swollen and painful joints, the intensity of the pain, and the range of motion in the joints and spine. .. Therefore, you should follow up with your doctor's appointment. When experiencing any side effects of the drug, it is necessary to actively notify the doctor to change to another suitable and safer drug. In order to treat ankylosing spondylitis effectively in the first place, the disease needs to be diagnosed early, thereby contributing to maintaining joint flexibility and mobility. Therefore, you should quickly go to the internal musculoskeletal departments in major hospitals for proper examination and diagnosis if you suspect you have the disease. Currently, Vinmec International General Hospital is one of the leading prestigious hospitals in the country, trusted by a large number of patients for medical examination and treatment. Not only has the physical system, modern equipment: 11 ultrasound rooms, 4 DR X-ray rooms (1 full-axis machine, 1 light machine, 1 general machine and 1 mammography machine) , 2 DR mobile X-ray machines, 03 multi-row computer tomography rooms with receivers (1 128-series, 1 512-series and 1 640-series), 04 Magnetic resonance imaging rooms (3 3 Teslas and 1 1.5 Tesla machine), 1 interventional angiography room with 2 planes and 02 rooms for measuring bone mineral density.... Vinmec is also the place to gather a team of experienced doctors and nurses who will greatly assist in the treatment. Diagnosis and early detection of abnormal signs of the patient's body. In particular, with a space designed according to 5-star hotel standards, Vinmec ensures to bring the patient the most comfort, friendliness and peace of mind.
Please dial HOTLINE for more information or register for an appointment HERE. Download MyVinmec app to make appointments faster and to manage your bookings easily.
