BEKHTEREVA DISEASE

BEKHTEREVA DISEASE (syn: ankylosing spondylitis) is a chronic inflammatory disease of the spine and joints. Most often sick male face at a young age. The cause of the disease is unknown, and its development is given importance to certain genetic factors.

The disease often begins with pain and morning stiffness in the lumbar and (or) sacral region of the spine, in the buttocks. Unlike pain caused by osteochondrosis of the spine, pain with Bechterew's disease decreases with movement (articular syndrome is often accompanied by fever, fatigue, decreased appetite, anemia). Over time, patients, trying to involuntarily reduce the pain and spasm of the invertebral muscles, get used to the bent position, develops thoracic kyphosis - the characteristic pose of the "petitioner". Pain and limitation of mobility appear in the thoracic and cervical spine, thorax. In more than half of cases arthritis of peripheral joints, more often of large joints of lower extremities, is noted. It is also characteristic to involve in the process of such inactive joints, such as sternoclavicular and rib-breast. Affected mucous bags in place of attachment of tendons and ligaments to bones - bursitis develops. More often this process is observed in the area of ​​the heels and is accompanied by pain when walking. In a number of cases, there may be an iridocyclitis (more often one-sided), aortitis , heart damage (myocarditis, pericarditis); Often increased ESR (up to 50 - 60 mm / h and more). With a prolonged course, approximately 5% of patients develop amyloidosis . The course of the disease is progressive, with exacerbations and remissions.

In the diagnosis of Bechterew's disease, roentgenography of the spine and pelvis is of great importance. The characteristic and the earliest radiologic symptom of the disease is bilateral sakroileitis (arthritis of the sacroiliac joints). In later stages, as a result of ossification of the fibrous rings of the intervertebral discs, syndesmophytes are formed (the x-ray symptom of the "bamboo stick").

Treatment includes mandatory continuous intake of one of the following drugs - indomethacin, voltaren or butadione; Regular exercise in physiotherapy in order to maintain sufficient mobility of the spine, massage the muscles of the back. Phonophoresis of hydrocortisone, inductotherapy on the spine area are also applied. With arthritis of peripheral joints, it is necessary to insert corticosteroids into their cavity. When the activity of the disease subsides, hydrosulfide or radon baths are prescribed. Patients should be under the dispensary supervision of a rheumatologist.

The outcome of the disease is the limitation of spinal mobility due to ankylosing of intervertebral joints and ossification of fibrous rings of intervertebral discs. In the absence of amyloidosis, the prognosis for life is favorable. Timely treatment can significantly slow the progression of the disease.