Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Ankylosing Spondylitis

Ankylosing spondylitis, also known as Bechterew’s disease or pelvospondylitis ossificans, mainly affects the sacroiliac joint, the joints between the vertebral arches and the anterior long ligament of the spine, which may gradually ossify. It usually afflicts young and middle-aged men and should be suspected in cases of chronic, but not severe, pain in the lumbar region. The condition is always associated with other disorders. Of the men who suffer from this disease, about 75% have chronic inflammation of the prostate gland (chronic
prostatitis), 20% have intestinal inflammation, and 5% have psoriasis. In women, ankylosing spondylitis is connected with intestinal disease in 80%, with recurrent urinary tract infection in 15%, and with psoriasis in
5%.

Symptoms and diagnosis

– Stiffness and pain are felt in the morning.
– Aching in the back disturbs sleep at night.
– Pain radiates out towards the groin and down into the legs.
– Other joints can also be affected, e.g. hip, shoulder, and toe joints. Increasing kyphosis may appear.
– Recurrent eye inflammations (iritis) may occur.
– Special blood tests may confirm the diagnosis.
– An early bone scan is valuable.
– An X-ray examination of the sacroiliac joint can show irregularities in the joint. When the thoracic and lumbar regions are X-rayed, early ossification of the anterior long ligament can be identified as well as
an increase in the angularity of the shape of the vertebrae.

Treatment

The athlete should:
– relieve stress on the affected joints;
– avoid rapid twisting movements;
– avoid cold and drafty conditions;
– use a heat retainer;
– consult a doctor.
The doctor may:
– prescribe exercises and physiotherapy to counteract incorrect posture and increase mobility in back, shoulders, and hips;
– prescribe anti-inflammatory medication;
– treat other associated diseases.

Healing and complications

Active mobility training should be commenced at an early stage, but the disease from which the patient suffers in addition to ankylosing spondylitis should be treated before training and competition are resumed. In the early stages and during symptom-free periods, sporting activities can be continued without major limitations, though a doctor should be consulted. During active exacerbation sporting activity should be limited.

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