Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P01889 (ankylosing spondylitis)
 5,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

As part of the 3E program, we conducted a systematic literature review and gathered consensus from 23 practising Australian rheumatologists to develop guidelines for early identification of ankylosing spondylitis and specialist referral. In three rounds of break-out sessions followed by discussion and voting, the specialist panel addressed three questions related to diagnosis of ankylosing spondylitis: In individuals with back pain, what are the early clinical features that suggest ankylosing spondylitis? How useful is imaging in identifying early ankylosing spondylitis? Based on which clinical features should a general practitioner refer a patient to a rheumatologist for further evaluation? The panel agreed on six recommendations related to the three questions: 1a. Early clinical features to suggest ankylosing spondylitis include inflammatory back pain and age at symptom onset < 45 years. 1b. The absence of symptomatic response to an appropriate course of non-steroidal anti-inflammatory drugs makes the diagnosis of ankylosing spondylitis less likely. 1c. Raised inflammatory markers are supportive, but their absence does not rule out the diagnosis of ankylosing spondylitis. 2a. Despite low sensitivity to detect changes of early ankylosing spondylitis, plain radiographs of the pelvis and spine are appropriate initial imaging techniques. 2b. Magnetic resonance imaging is a useful imaging modality for detecting early changes of ankylosing spondylitis. 3. Individuals with inflammatory back pain should be referred to a rheumatologist for further evaluation. Effective dissemination and implementation of these recommendations are important to standardise the approach to early diagnosis of ankylosing spondylitis.
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PMID:Evidence-based recommendations for the diagnosis of ankylosing spondylitis: results from the Australian 3E initiative in rheumatology. 1827 32

Detection of preradiographic sacroiliitis is important for early diagnosis of ankylosing spondylitis (AS) and related spondyloarthropathies. Magnetic resonance imaging (MRI) is a valuable tool for the diagnosis of sacroiliitis in the early and active stages. The aim of this study is to assess the value of pain provocation tests in detecting early active sacroiliitis. Chronic low-back pain (LBP) patients were recruited and examined by blinded assessors for pain provocation tests: compression, distraction, Gaenslen, Mennel, Patrick, thigh thrust and sacral thrust tests. Patients underwent lumbar and sacroiliac MRI. The percentage of agreement for each pain provocation tests was between 72-95%, and the inter-rater reliability was from moderate to good (kappa, 0.43-0.87). Kappa values ranged from 0.43 to 0.60 with an agreement of 80-95% for clusters of pain provocation tests. As separately evaluated, pain provocation tests did not have favorable accuracy. When evaluated in clusters (out of three and five provocation tests) four positive over five tests on the left side reached an area under the curve 0.693 (95% CI 0.489-0.897), and two positive over three tests reached an AUC 0.697 (95% CI 0.484-0.910). Sacroiliac pain provocation tests had acceptable reliability in early active sacroiliitis; however, the discriminating capacity of these tests is poor. A multi-test regimen of three or five sacroiliac pain provocation tests may improve the accuracy of these tests discriminating sacroiliitis from LBP of mechanical origin. Four out of five selected tests or any of the two out of three selected tests have the highest predictive value.
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PMID:The value of sacroiliac pain provocation tests in early active sacroiliitis. 1845 88

This study focuses on the causes and consequences of delay in diagnosis of ankylosing spondylitis (AS). Seventy consecutive patients presenting at a rheumatology clinic in India were studied. Mean (+/-S.D) delay in diagnosis was 6.9 (+/-5.2) years. The main cause of delay was incorrect diagnosis as non-specific back pain (19/54, 35.1%), degenerative disc disease (14/54, 25.9%), rheumatoid arthritis (11/54, 20.37%), and tuberculosis of spine (9/54, 16.6%) in that order, for which the patient received prolonged treatment. Absence of extra-articular manifestations and juvenile age also significantly correlated with diagnostic delay. Delay in diagnosis resulted in significantly worse disease activity index (BASDAI), functional index (BASFI), and damage index (BASMI). Most incorrect initial diagnoses were made by orthopedicians (75.9%), followed by general physician (50%), and rheumatologist (12%). Continuing medical education workshops with a focus on clinical diagnosis of inflammatory back pain may help in early diagnosis of AS.
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PMID:Diagnosis delay in patients with ankylosing spondylitis: factors and outcomes--an Indian perspective. 1905 36

Inflammatory involvement of the sacroiliac joints is the hallmark of the spondyloarthropathies (SpA), in particular ankylosing spondylitis (AS). One leading symptom of SpA is inflammatory back pain (IBP), which may be indicative of sacroiliitis. Conventional diagnostic imaging is insufficient at early stages of sacroiliitis because of the low sensitivity of conventional radiographic scans. In contrast, magnetic resonance imaging (MRI) of the sacroiliac joints depicts both acute and chronic inflammatory changes at all stages of the disease. Disadvantages of MRI are the operator-dependency, the lack of standardization, and the relatively high costs. Therefore, in the era of cuts in health care expenditure, the Diagnostic Imaging in Rheumatology Study Group of the Berlin Regional Rheumatology Center, which consists of experienced rheumatologists, skeletal radiologists, and orthopedic surgeons, has compiled a survey of diagnostic imaging in sacroiliitis covering the clinical background, technical details, radiation exposure, and costs. Conventional x-rays remain the standard imaging procedure for the diagnosis of AS. Early sacroiliitis can be detected with higher sensitivity by MRI using contrast agents or fat suppression techniques. Because of its lack of radiation exposure, MRI is the method of choice in children and young women. MRI allows for a more accurate diagnosis of inflammatory back pain by providing objective evidence of inflammation in the sacroiliac joints. Computed tomography can be superior to MRI when bony changes have already occurred.
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PMID:Imaging of inflammatory rheumatic diseases of the axial skeleton (sacroiliitis): when and how should we use MRI? 1907 97

Spondyloarthritis (SpA), a family of inflammatory back diseases including ankylosing spondylitis, is an important and under-recognized cause of chronic back pain in younger patients who are likely to participate in sports and athletic activities. These diseases are characterized by the presence of inflammatory back pain--lumbar or buttock/hip pain lasting longer than 3 months associated with improvement with activity, worsening with rest, relief with non-steroidal anti-inflammatory drugs (NSAIDs), and morning stiffness lasting longer than 30 min. There are also characteristic radiographic findings involving the sacroiliac joints, vertebrae, and in certain diseases, the peripheral joints. Exercise has long been recognized as a key component of the therapy of SpA, yielding benefits in mobility, pain, stiffness, functionality, and depression. Sports also pose a risk to patients with SpA as these patients are at high risk of spinal fracture and spinal cord injury.
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PMID:Spondyloarthritis: clinical suspicion, diagnosis, and sports. 1914 77

Most of musculoskeletal diseases involve pain and reduced physical functioning. Recognition of the coexistence of more than one musculoskeletal disease is important because they are relatively common and has a substantial impact on health-related quality of life (HRQoL). Our aim was to compare the results of four generic QoL questionnaires--QoL-5, Nottingham Health Profile (NHP), Short Form (SF)-6D, and Visual Analogue Scale (VAS)--in five different patient groups. Two hundred and one patients representing five different disease groups (knee osteoarthritis, osteoporosis, back pain, rheumatoid arthritis and ankylosing spondylitis), randomly selected through the Ankara Numune Education and Research Hospital Physical Medicine and Rehabilitation Outpatient Clinic, were included in the study. Scores indicating low QoL for each of the five diseases compared are reported. Patients in each disease group stated high disability. No strong correlation between any of the scales could be determined, and NHP was identified as the only scale able to differentiate between the diseases. Many instruments are available for measuring HRQoL. The QoL-5, NHP, SF-6D, and VAS are four commonly used generic (i.e., not disease-specific) measures for quantifying HRQoL in patients with musculoskeletal disorders. Most studies have focused on only one musculoskeletal disease, but comorbidity of musculoskeletal disorders is common. We emphasize in this study the effect of multiple musculoskeletal diseases on HRQoL.
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PMID:A comparison of four different HRQoL generic questionnaire in five different patient groups. 1937 68

Inflammatory back pain is more than just inflammatory pain, but a set of symptoms which presence must evoke a diagnosis of ankylosing spondylitis. However, it is insufficient by itself for a diagnosis which can only be reach as part of a diagnostic strategy searching for other clinical, biological or radiological abnormalities in order to obtain adequate diagnostic probability, while acknowledging the limitations of all these examinations.
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PMID:[Inflammatory back pain]. 1940 72

Inflammation of axial and/or peripheral joints is one of the most frequent extra-intestinal manifestations complicating the clinical course and therapeutic approach in inflammatory bowel diseases (IBD). The frequency of these complications seems to be similar for both diseases, Crohn's disease and ulcerative colitis. Arthritis associated with IBD belongs to the category of spondyloarthropathies. Axial involvement ranges from isolated inflammatory back pain to ankylosing spondylitis, whereas peripheral arthritis is noted in pauciarticular and in polyarticular disease. Asymptomatic radiological involvement of the sacroiliac joints is reported to occur in up to 50% of patients. Other musculoskeletal manifestations such as buttock pain, dactylitis, calcaneal enthesitis, and thoracic pain are frequently underdiagnosed and, consequently, are not treated appropriately. Several diagnostic approaches and criteria have been proposed over the past 40 years in an attempt to correctly classify and diagnose such manifestations. The correct recognition of spondylarthropathies needs an integrated multidisciplinary approach in order to identify common therapeutic strategies, especially in the era of the new biologic therapies.
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PMID:Clinical features and epidemiology of spondyloarthritides associated with inflammatory bowel disease. 1946 93

The history of classification and diagnostic criteria for rheumatoid arthritis (RA) and ankylosing spondylitis (AS) is similar and different. Important criteria sets have been published for both disease in the mid eighties, for AS in 1984 and for RA in 1987. The leading clinical symptoms, inflammatory back pain (IBP) in AS and the predominant polyarticular symmetric involvement of the hands in RA were, of course, central, and so was morning stiffness as a major clinical sign of an inflammatory disease state. In RA, there was more focus on laboratory parameters (rheumatoid factor), while this could have been the case also in AS (HLA B27) but this was not recognized at this point in time. In contrast, imaging has played a more important role in AS - especially because the sacroiliac joints are involved in the vast majority of AS patients, while in RA radiographic changes of the joints of hands and feet may contribute to the diagnosis. However, in both diseases, early structural changes visualized by conventional radiography rather have prognostic impact since these patients are much more likely to progress in comparison to others who do not have cartilage and joint damage early in the course of the disease. Further developments of criteria for AS have broadened the spectrum of AS to spondyloarthritis (SpA) and axial SpA which covers most early forms. The leading clinical symptom is chronic back pain in young adults and IBP. New criteria for RA which include more patients with early disease and anti-CCP antibodies as new markers are being developed. This is important since early treatment strategies are increasingly and successfully used to treat inflammatory diseases more efficiently.
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PMID:Classification criteria for rheumatoid arthritis and ankylosing spondylitis. 1982 49

There is a clear need to assess patients presenting with a new onset of inflammatory peripheral arthritis and/or back pain early. Indeed, the clinical presentation of rheumatoid arthritis (RA) is not always characteristic but its early diagnosis is crucial to prevent irreversible structural damage. Likewise low back pain is common in the general population but may be related to ankylosing spondylitis (AS) and other axial spondyloarthritis (SpA) in up to 5% of cases. Mounting evidence suggests that early intervention leads to improve outcome both in RA and SpA which has important socioeconomic implications. Early inflammatory clinics (EIC) should therefore be considered in every rheumatology department to facilitate the early assessment and diagnosis of these patients allowing for prompt and targeted therapeutic intervention. In addition the EICs allow for a better focused follow-up of these patients in appropriate secondary clinics. Since the sustained remission of inflammatory and autoimmune diseases such as RA is highly dependent on how early treatment is instigated and its efficacy regularly assessed, there is legitimacy for the EICs. Furthermore, there is a clear research interest in building early inception cohorts that allow for the characterization of the different disease phenotypes.
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PMID:Early inflammatory clinics. Experience with early arthritis/back pain clinics. 1982 50


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