What is Rheumatoid Spondylitis ?

Read about Rheumatoid Spondylitis Disease presented in simple easy to understand language

Laboratory Diagnosis
• ESR is elevated in 80% of the cases but correlates poorly with disease activity and prognosis. 
• Absent rheumatoid factor. 
• Synovial fluid : mild leucocytosis, decreased viscosity. 
• HLA – B27 present in 80% to 90% of the cases. 
• Cerebrospinal fluid – increased protein. 

Imaging
• Sacroiliac joint early : Sclerosis on both sides of joint not extending more than 1 cm from articular surface. 
• Sacroiliac joint late : Ankylosis of sacroiliac joint. 
• Spine – ossifiication of annulus fibrosis giving appearance of bamboo spine. Ankylosis of facet joint. 

General Management
1. Firm bed and sleep in prone position or supine without a pillow 
2. Range of motion exercises for neck and spine are essential to maintain mobility. 
3. Breathing exercises two to three times a day to maintain chest expansion and rib mobility. 
4. Strengthening exercises to keep muscles erect and upright. Always keep your back straight. 
5. Swimming, physiotherapy. 
6. Stop smoking and encourage active lifestyle. Avoidance of excess mechanical stress from daily activities. 
7. Inflammation of the eye should be treated accordingly. 
8. Pulmonary infection, if present, should be promptly treated. 
9. Surgery like osteotomy of the spine may be indicated for severe deformity. 

Expected Prognosis
Prognosis is good if mobility and upright posture are maintained. If the disease remains unchecked, it can lead to progressive disability. While spinal stiffness is to be avoided, even greater potential disability can occur if it affects the hips, knees or shoulders. The hip joints are quite often involved and can progress to where the joint is damaged, becoming limited in mobility, and painful. Total hip replacement through surgery is the only solution for end stage of hip damage. Those who die with this disease usually develop some respiratory infection owing to reduced vital capacity resulting from the ankylosis of the costovertebral joints. Some may develop aortic incompetence. However, if treatment is applied on time a patient can lead a reasonably active life in a fairly erect posture.  Read Previous