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Ankylosing Spondylitis (In-Depth)

A chronic inflammatory rheumatic disease affecting the spine and sacroiliac joints.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Dahiliye (İç Hastalıkları) department. Book Appointment →

What is Ankylosing Spondylitis (In-Depth)?

Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease that affects the axial skeleton, particularly the sacroiliac joints and the spine. Over many years, slowly progressive joint ossification takes place and in severe cases spinal movement becomes markedly limited.

The most striking genetic marker is HLA-B27, which is positive in about 90 % of patients. AS is most common in young-adult men aged 20–40. Morning stiffness and inflammatory back pain that improves with exercise are characteristic features.

MRI plays a critical role in early diagnosis by showing active inflammation in the sacroiliac joints (oedema, erosive change) before ossification develops. Biologic agents (TNF and IL-17 inhibitors) have revolutionised treatment and slow disease progression.

Symptoms

Inflammatory back pain lasting more than three months
Morning stiffness of more than 30 minutes
Back or hip pain that wakes the patient at night
Reduced chest expansion and discomfort on breathing
Pain in the hip and shoulder joints
Episodes of uveitis (red, painful eye)
Heel pain (enthesitis) and Achilles tendinitis

Risk Factors

HLA-B27 positivity
A family history of ankylosing spondylitis
Male sex (2–3 times more common)
Young age (onset between 20 and 40)
Recurrent episodes of uveitis
Coexisting inflammatory bowel disease
A history of psoriasis
Smoking (accelerates disease progression)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Morning stiffness and back pain lasting more than three months
  • Back pain that wakes the patient at night
  • Pain that improves with exercise and worsens with rest
  • Blurred vision with a red eye
  • Early screening when there is a family history of ankylosing spondylitis
  • Inadequate response despite NSAID therapy

Treatment Methods

01
NSAIDs are first-line therapy (continuous or intermittent)
02
TNF-α inhibitors (adalimumab, etanercept, infliximab, certolizumab)
03
IL-17 inhibitors (secukinumab, ixekizumab)
04
JAK inhibitors (tofacitinib, upadacitinib) for resistant cases
05
Regular physiotherapy and postural exercise
06
Smoking cessation and weight control
07
Collaboration with ophthalmology for uveitis attacks
08
Hip arthroplasty in advanced cases

Which Department to Visit?

You can visit our Dahiliye (İç Hastalıkları) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.