Ankylosing spondylitis, is a chronic disease of the joints of the spine. Its main characteristic is a complex inflammatory process, which is difficult to treat and limits the functionality of a person.
WHAT IS ICD 10 AND WHAT REASONS
Ankylosing spondylitis (code for microbial count 10 – M45) was first described by a Russian doctor neuropathologist Vladimir Bekhterev (hence the second name of the disease).
At the initial stage, the lesion falls on the sacral or pelvic spine. There is stiffness, acute pain, local hyperthermia, and the activity of a person decreases. In the process of developing the disease, inflammation intensifies. Can ankylose pelvic, shoulder, ankle, knee, intercostal, intervertebral joints. A variety of disorders join this ailment: osteoarthritis, myocarditis, anemia, arrhythmia, inflammatory processes of the kidneys, arthritis, eye diseases.
The incidence of spondylitis is 6 patients per 1000 healthy people. Men are more prone to disease. They suffer 5 times more often than women. Ankylosis of the spine begins to appear at the age of 20 to 40 years.
The International Classification of Diseases of Revision 10 (ICD-10) characterizes ankylosing spondylitis as a disease of the musculoskeletal system and connective tissue, which is part of the group of dorsopathies, a class of spondylopathies. According to ICD 10, this ailment is identified under the code M45.
The true cause of development has not yet been revealed. Some scientists agree that the pathogenesis of this condition is a specific antigen, HLA-B27. Therefore, the disease is classified as autoimmune. It was found that only 85% of patients with axial spondylitis have the indicated antigen. This raises some doubts.
Ankylosing spondylitis or spondylitis can complicate life, immobilize a person, turning the spine into a bone monolith. With a serious lesion, inflammation can affect the internal organs, causing myocarditis, osteomyelitis.
SYMPTOMS AND DIAGNOSTICS
At the initial stage of the disease, a person begins to notice discomfort in the lumbar region. Mild pain, a feeling of stiffness, especially in the morning or evening, may occur. With the development of the ailment, pain in the neck, thoracic region can be observed. It becomes difficult to fully inhale.
Spinal mobility decreases in several stages. At the same time, the skeleton is shortened. The spine is deformed into an arcuate shape, the upper and lower extremities remain bent at the elbows, knees. The patient’s body takes on the so-called “petitioner” pose.
A diagnostic study for the presence of idiopathic ankylosing spondylitis begins in the doctor’s office. After a physical examination, the patient is assigned a hardware diagnosis, a number of clinical studies to make a correct diagnosis.
The patient undergoes an x-ray examination. In X-ray images, there will be obvious changes in the inert structure. For additional information, the use of computed and magnetic resonance imaging is relevant. A blood test will provide information about the presence of an inflammatory process.
To determine the disease, differential diagnosis is needed. General signs of the disease associated with pain in the back and limbs are inherent in other diseases of the musculoskeletal system. Spondylarthrosis has similar symptoms, but their treatment approach is different. Rheumatoid arthritis should also be ruled out.
FORMS AND TYPES OF DISEASE
Depending on the degree of damage, the localization of the focus of the inflammatory process, 5 main forms of ankylosing spondylitis are distinguished:
- The central form of spondylitis. In this case, the lesion falls on the human spine. With the development of the disease, the symptoms intensify. Asphyxia attacks, muscle cramps can occur, and hypertension occurs.
- The rhizomelic form is characterized by lesions of the spine and large joints (mainly the shoulder, femoral, pelvic). The disease also develops slowly. Pain in the lower back is given to the gluteal or inguinal zone. Discomfort of the limbs may be observed.
- With the peripheral form of the disease, the region of the sacroiliac joints is the first to suffer. After a certain time, the joint structure of the feet and knees is affected. More often this form of the disease occurs in adolescents and young people than in adults.
- The Scandinavian form is characterized by the same signs as the peripheral one, with one difference – small joints are more affected (similar to rheumatoid arthritis). Destruction appears in the hands, feet. This form is not characterized by the presence of severe pain symptoms.
- The visceral form may mean one of the above forms with the addition of lesions of the internal organs.
In addition to deforming spondylitis, cervical and lumbar are distinguished. The first affects the upper part of the spine, the damage falls on the cervical vertebrae and clavicle. Due to muscle atrophy, immobility of the upper extremities is observed. The second – characterizes the affecting of the lumbar spine.
TYPES OF TREATMENT
Treatment of ankylosing spondylitis is long and time-consuming. It continues until remission. Most often this is a set of measures, the bulk of which is carried out under the conditions of a hospital.
- The use of non-steroidal anti-inflammatory drugs is necessary to eliminate the inflammatory process (Diclofenac, Ketoprom, Ibalgin). Drugs block the production of prostaglandins, which are responsible for the occurrence of inflammation. Long-term use of such drugs causes gastrointestinal upset.
- Use of glucocorticoids or steroids. When hormonal substances enter the body, the immune system is suppressed. Due to this, the process of inflammation stops. Taking such medications has many contraindications and a wide list of side effects. The duration of treatment should be limited.
- With a particularly severe course of the disease, they resort to the introduction of immunosuppressants. These drugs weaken the immune system and prevent further self-destruction of the body. To treat this ailment, one of the listed drugs is prescribed – Methotrexate, Cyclosporin, Azathioprine, Ridaura, Penicillamine, Solganal or Sulfasalazin.
- Physiotherapeutic procedures include therapeutic massages, vacuum therapy, warming up.
- Manual therapy is also used in the complex treatment of spondylosis. This includes reflexology, acupuncture, acupressure.
- The complex of exercise therapy is an important component of the treatment of such diseases. Physiotherapy exercises can delay the process of destruction, expand the breadth of movements, eliminate pain.
During treatment and remissions, a person is prescribed rest in sanatorium institutions. Swimming and morning exercises are also helpful.
Some people resort to traditional medicine. It is important to understand that the practice of treating spondylitis at home is unjustified and carries many threats regarding human health.
The surgical treatment is rarely used due to the complexity of its providence. The incentive for the operation can serve as the young age of the patient and the lack of response to drug treatment.
EATING AND DIET
Proper nutrition is a necessary measure if ankylosing spondylitis, spondylarthritis, or spondylarthrosis progresses. The main objective of the diet is to enrich the body with useful substances. During the use of medicines, most of the important trace elements are washed out of the tissues, the supply of which must be replenished.
The second important task of special nutrition is weight loss. Excess kilograms create an unnecessary strain on the spine. During treatment, the patient should formulate a new menu, reduce the daily norm of kilocalories to 1000 units.
There are some nutritional recommendations that you must adhere to during the treatment of spondylitis:
- salt, fast carbohydrates and dairy products should be removed from the diet;
- meat should be dietary and steamed;
- avoid or reduce the consumption of starchy foods;
- exclude instant food from consumption;
- give preference to vitamin drinks (juices, fruit drinks, compotes);
- dairy products should be with a minimum percentage of fat content.
Observance of all nutritional conditions will help regulate metabolic processes in the body, improve the digestive tract, eliminate excess body weight.
To prevent the development of ankylosing spondylitis, a person should organize the right lifestyle. It is necessary to lead an active lifestyle, but physical activity should be moderate, alternating with good rest. Regular balanced nutrition is also a necessary measure to prevent ankylosing spondylitis. It is necessary to avoid situations that threaten hypothermia and spinal injuries.
Ankylosing spondylitis is a dangerous chronic disease that requires a quick response and lifestyle correction. Ignoring the symptoms and self-treatment can lead to exacerbations of the disease, as a result of complete disability of a person.
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