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Critical Reviews™ in Physical and Rehabilitation Medicine
SJR: 0.121 SNIP: 0.228 CiteScore™: 0.17

ISSN Druckformat: 0896-2960
ISSN Online: 2162-6553

Critical Reviews™ in Physical and Rehabilitation Medicine

DOI: 10.1615/CritRevPhysRehabilMed.v10.i3.40
pages 265-301

A Critical Review of Ankylosing Spondylitis

Nicola H. Ryall
Rheumatology and Rehabilitation Research Unit, University of Leeds, 36, Clarendon Road, Leeds, LS2 9NZ
P. Helliwell
Cornwall Dermatology Research, Peninsula Medical School, Truro, UK TR1 3HD


Ankylosing spondylitis is a progressive, inflammatory, axial, and peripheral arthropathy of unknown etiology. Ankylosing spondylitis is a chronic debilitating disease. It affects the axial spine with pain, loss of mobility, osteoporosis, and increased fracture rate. It may also cause peripheral arthritis, as well as having many extraarticular multisystemic manifestations. The underlying lesion is believed to be enthesitis. Risk factors include being young, male, and a positive HLA-B27 antigen. The role of gut pathogens is less clear. In recent years major advances have occurred in pathogenesis, yet we still do not know the precise natural history or the optimal treatment strategy. A multidisciplinary approach to treatment is recommended, centered around patient knowledge and education as well as exercise and physiotherapy. Simple analgesics and antiinflammatory drugs also play important roles. As outcome is variable, ankylosing spondylitis needs long-term monitoring and management. This has important economic implications.