Ankylosing Spondylitis
In this article we explore ankylosing spondylitis in more detail, explaining what it is, how it is caused, how it is diagnosed and treated, and any potential complications.
If you would like to talk to us about a possible medical negligence claim relating to ankylosing spondylitis, please get in touch with us today at Glynns Solicitors.
What is Ankylosing Spondylitis?
Ankylosing spondylitis (AS) is a type of arthritis. It causes inflammation in the joints, usually in the spine although other areas of the body can be affected.
While AS is mainly associated with the back, inflammation can occur in any joint, such as the knee or hip. It can also arise at sites where ligaments join to bones (like the Achilles tendon), and even in the organs such as the bowel, eye and skin.
What causes Ankylosing Spondylitis?
It is not really known what causes ankylosing spondylitis. Experts believe it is an inherited condition linked with the gene HLA-B27. It is also known that men are much more likely to be affected than women. Most cases of AS begin to develop when the patient is in their late teens or early adulthood.
What are the symptoms of Ankylosing Spondylitis?
During to the varying nature of ankylosing spondylitis, different people will develop different symptoms. Typically there will be pain and stiffness in the back that is worse in the mornings. There may also be pain in other joints with notable swelling. Most patients also report feeling extremely tired.
AS can progress very slowly, with symptoms coming and going over a period of years. Lots of people find that their symptoms will improve with exercise and movement, and will worsen again with rest and reduced mobility.
How is Ankylosing Spondylitis diagnosed?
There is no set test for ankylosing spondylitis. Instead medical practitioners must look at the appearance of your bones and investigate for signs of infection.
The diagnostic process begins when the patient presents to their GP with a history of joint pain, inflammation and fatigue. The long-term nature of the patient's symptoms should indicate a chronic inflammatory condition. Suspicions should be particularly heightened if the patient has a family member with AS, as it is known to be an inherited condition.
The first step is to take a blood test to check for inflammatory markers. These will be raised in someone who has AS. If there are abnormalities, the GP should refer a patient to a rheumatologist for imaging tests, such as an MRI scan. This can show spinal inflammation and fusing. If there has been fusion there will be a 'bamboo spine', where the vertebrae become crooked.
Nevertheless, bamboo spine may not occur for years after the patient first starts to experience symptoms. This can make it difficult to verify the condition. In such cases, a patient who has a three-month history of joint pain that improves with exercise, an inflammatory markers in their blood, can be diagnosed with probable AS. This can be confirmed once spinal abnormalities begin to appear, or if the HLA-B27 is identified.
How is Ankylosing Spondylitis treated?
Ankylosing spondylitis cannot be cured. Instead, treatment is focused upon managing a patient's symptoms and limiting the amount of damage sustained by the joints.
Physiotherapy and exercise are known to benefit people with AS because they help keep the spine mobile, rather than stiff and painful. Pain-relief medication and anti-inflammatories can reduce pain and discomfort.
If symptoms cannot be controlled with these treatment, medication can be prescribed to block the production of a protein called tumour necrosis factor (TNF). People with AS produce too much of this protein, which contributes towards the inflammation in the joints.
Complications of Ankylosing Spondylitis
Ankylosing spondylitis can additional complications, either as a result of bone damage or inflammation. Complications of AS can include:
- Surgery – if a joint becomes very damaged and/or is extremely painful, a joint replacement may be necessary. This might include hip replacement or spinal surgery.
- Iritis – iritis is when the eye becomes inflamed. The eye will become red and painful, and vision will be blurry and sensitive to light.
- Colitis – colitis is when the large bowel (the colon) becomes inflamed. It will cause stomach cramps, diarrhoea and blood in the stool.
- Psoriasis – psoriasis is when the skin becomes inflamed, resulting in itchy, flaking patches across the body. This will affect around 15% of AS patients.
- Osteoporosis – the spinal vertebrae can become particularly weak in people with AS and the bones can fracture or prolapse.
- Cauda equina syndrome – if a spinal fracture or disc prolapse in the lower back pushes on the cauda equina nerves, it can lead to a condition called cauda equina syndrome.
Ankylosing spondylitis and medical negligence
If these complications occur but are not adequately managed by medical practitioners, the damage could be severe. The same is true if medical practitioners fail to diagnose a patient with AS, despite the patient repeatedly seeking medical help. This is because the disease will progress when it could have been contained, causing the patient unnecessary harm.
Missed spinal fractures and missed cauda equina syndrome are particularly dangerous. A failure to diagnose and treat such complications on an emergency basis could leave the patient with a very poor outcome. There can be a significant loss of mobility, and with cauda equina syndrome there can even be incontinence and sexual dysfunction.
If you have suffered a bad outcome and you think more could have been done to prevent your injuries, you might wonder whether substandard medical care is to blame. If the care was inadequate and this caused you harm that could otherwise have been avoided, there will be a case of medical negligence.
Medical negligence claims solicitors
To find out more about medical negligence and claiming compensation, please get in touch with our team at Glynns Solicitors. We specialise in medical negligence claims and can advise whether your AS/AS complications were appropriately diagnosed, treated and managed. If we believe there is a case to be investigated, we will pursue a claim on your behalf.
Call us free on 0800 234 3300 (or from a mobile 01275 334030) or complete our Online Enquiry Form.
Make An Enquiry
Why Choose Us
- Specialist medical negligence solicitors
- Free initial enquiries
- No win, no fee available
Reviews
"I would like to say a big thank you to you for making this whole process easy and relatively painless. You kept me informed throughout and you were always polite and courteous in all forms of communication. I would not hesitate to recommend you to friends and family, so a really big thank you and I wish you all the best in the future."
Mr A.
Our Expertise
Helping Clients Across England & Wales
Free Medical Negligence Guide
'7 Questions You Must Ask Before Choosing A Medical Negligence Solicitor'