axSpA

Ankylosing spondylitis (axSpA) is a chronic inflammatory rheumatic disease primarily affecting the axial skeleton, especially the sacroiliac joints and the spine. It belongs to the broader category of spondyloarthritis and is characterized by inflammation that can lead to pain, stiffness, and eventual fusion of the affected joints. The condition typically begins in young adults, with a higher prevalence among males.

The exact cause of axSpA is unknown, but it involves a combination of genetic and environmental factors. The presence of the HLA-B27 gene is a significant genetic marker associated with the disease, though not all individuals with this gene develop axSpA. Environmental triggers such as infections may also play a role in disease onset.

Symptoms commonly include chronic lower back pain and morning stiffness that improve with activity. Over time, there may be reduced spinal flexibility and posture changes due to new bone formation. Extra-articular manifestations, such as uveitis, inflammatory bowel disease, and psoriasis, can occur in some cases.

Diagnosis involves clinical assessment, imaging techniques like X-rays and MRI to detect inflammation and structural changes, and laboratory tests for markers of inflammation. There is no cure for axSpA, but treatment aims to control symptoms and prevent progression. Nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, and exercise are first-line therapies. In more severe cases, biologic agents such as tumor necrosis factor (TNF) inhibitors may be prescribed to suppress inflammation.

Prognosis varies depending on disease progression and response to treatment. With appropriate management, many individuals can maintain a good quality of life and preserve spinal mobility. Early diagnosis and ongoing care are crucial for optimal outcomes.