Ankylosing spondylitis (Bekhterev's disease)

Medicine 3

Head of Department:
Prof. Dr. med. univ. Georg Schett

Understanding causes

Source: Merckle Rheumatologie visual, 3rd edition, Georg Thieme Verlag

Ankylosing spondylitis is characterized by inflammation of the vertebral body with pain and stiffening of the joints. The reasons for this disease are not yet fully understood. It is assumed that there is an immunological disorder that is genetically caused. Ankylosing spondylitis is one of the autoimmune diseases in which the immune system turns against one's own body.

 

Facts and figures about the disease

Ankylosing spondylitis is one of the chronic inflammatory rheumatic diseases. In principle, anyone can develop ankylosing spondylitis regardless of sex, although the symptoms can be weaker in women than in men.

  • In Germany, 400,000 to 500,000 people suffer from ankylosing spondylitis
  • The disease is usually diagnosed between the ages of 15 and 35

Typical symptoms and course of the disease at a glance

The first sign of the disease is a deep-seated inflammatory pain in the back and/or buttocks caused by an inflammation of the joints between the sacrum and ilium.

In the further course

  • Inflammation of the tendon insertions (e.g. at the heel)

Possible concomitant diseases

    • Involvement of the entire spine up to the stiffening of the spine
    • Iritis
    • Psoriasis
    • Chronic inflammatory bowel diseases (e.g. Crohn's disease)
    • Inflammation of the knee and ankle joints often with asymmetrical infestation pattern

    How does the physician make the diagnosis?

    • Questioning the patient about back pain, other symptoms, concomitant diseases and family disposition
    • Measurement of blood sedimentation rate (BSG) and C-reactive protein (CRP)
    • Blood test whether HLA-B27 positive
    • Use of imaging techniques: X-ray, sonography, computer tomography or magnetic resonance tomography

    How is ankylosing spondylitis/Morbus Bechterew treated?

    • The pain is mainly treated with drugs from the class of non-steroidal anti-inflammatory drugs, such as ibuprofen and diclofenac, which on the one hand inhibit inflammation and on the other hand alleviate back or pelvic pain if taken regularly.
    • Glucocorticoids are preparations containing cortisone, which have a strong anti-inflammatory effect and have an immunosuppressive effect, i.e. they reduce certain reactions of the immune system so that, for example, new bone formation no longer takes place.
    • Biologics regulate the activities of the immune system. The inflammation processes are slowed down by a blockade of the tumor necrosis factor-α and prevent new inflammations in the joints.

    Practical tips for everyday life

    A well balanced, low meat diet, regular sporting activity, nicotine abstention.

     
    Actual clinical trial

    You have Morbus Bechterew and your medication take no effect?

    We can examine exactly your bone status on basis of high resolution computed tomography imaging to optimize your state of health by innovative medication.

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