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    Ankylosing Spondylitis, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Ankylosing Spondylitis, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Ankylosing Spondylitis, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Ebook157 pages1 hour

    Ankylosing Spondylitis, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

    By Kenneth Kee

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    About this ebook

    Ankylosing Spondylitis is a chronic medical inflammatory disorder of the joints of the spine manifested by fusion (ankylosing) and inflammation (spondylitis) of some or all of the joints and bones of the spine.
    It is a painful progressive disease involving mainly the spine.
    It can also induce inflammation of the joints between the spinal bones and the joints between the pelvis and spine.
    These joints become inflamed and fused.
    Over time the affected spinal bones join together.
    It can involve also other areas such as eyes, bowels, lungs, and heart.
    Every person can get Ankylosing Spondylitis.
    The age of start is normally in the late teens or early 20's.
    The disorder most often starts between ages 20 and 40 but it may occur before age 10.
    It is also more common in men than women about 3:1.
    In men the spine and pelvis are most affected.
    In women the pelvis, hips, knees, wrists and ankles are more frequent.
    The cause is not known but involves the interaction of genetic and environmental factors.
    Inflammation happens at the insertions of the ligaments and tendons to the bone.
    The erosion of the bones happens at the site.
    When the inflammation subsides, new bone forms and replaces the elastic tissues of the ligaments or tendons.
    It is sometimes called bamboo spine.
    This normally begins in the vertebra of the spine then involves the pelvis, then goes towards to the chest wall and neck.
    Symptoms may be slight in early stages or mild disorder, with an insidious onset over several months to years.
    The onset is usually gradual with occasional back pain over weeks or months.
    The disease starts with low back pain that keeps recurring.
    Stiffness and pain are worse at night, in the morning or when the patient is not active.
    There is often a feeling of tenderness of the sacroiliac joints or a limited range of spinal motion.
    Chest expansion can become limited because the joints between the ribs become stiff.
    Sometimes peripheral joints such as shoulders and hips are affected.
    Some may be very mild needing only exercises or mild pain killers.
    Others may be more serious needing strong NSAIDS or RA medicines such as sulphasalazine
    Various medicines are given to reduce swelling and suppress the immune system.
    a. Corticosteroid therapy such as prednisone
    b. Methotrexate (taken once a week)
    c. TNF-inhibitors
    Surgical treatment may be performed if pain or joint injury is serious.
    AS is a chronic disorder for which there is presently no cure.

    TABLE OF CONTENT
    Introduction
    Chapter 1 Ankylosing Spondylitis
    Chapter 2 Causes
    Chapter 3 Symptoms
    Chapter 4 Diagnosis
    Chapter 5 Treatment
    Chapter 6 Prognosis
    Chapter 7 Spinal Stenosis
    Chapter 8 Back Pain
    Epilogue

    LanguageEnglish
    PublisherKenneth Kee
    Release dateOct 7, 2016
    ISBN9781370366903
    Ankylosing Spondylitis, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Author

    Kenneth Kee

    Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

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      Book preview

      Ankylosing Spondylitis, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions - Kenneth Kee

      Ankylosing

      Spondylitis,

      A

      Simple

      Guide

      To

      The Condition,

      Diagnosis,

      Treatment

      And

      Related Conditions

      By

      Dr Kenneth Kee

      M.B.,B.S. (Singapore)

      Ph.D (Healthcare Administration)

      Copyright Kenneth Kee 2016 Smashwords Edition

      Published by Kenneth Kee at Smashwords.com

      Dedication

      This book is dedicated

      To my wife Dorothy

      And my children

      Carolyn, Grace

      And Kelvin

      This book describes the Ankylosing Spondylitis, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

      (What You Need to Treat Ankylosing Spondylitis)

      This eBook is licensed for the personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

      If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

      Thank you for respecting the hard work of this author.

      Introduction

      I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Condition) for the benefit of my patients since 2007.

      My purpose in writing these simple guides was for the health education of my patients.

      Health Education was also my dissertation for my Ph.D (Healthcare Administration).

      I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.

      This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Conditions into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

      From which many free articles from the blog was taken and put together into 700 amazon kindle books and some into Smashwords.com eBooks.

      Some people have complained that the simple guides are too simple.

      For their information they are made simple in order to educate the patients.

      The later books go into more details of medical conditions.

      The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

      Since 2013, I have tried to improve my spelling and writing.

      As I tried to bring you the latest information about a condition or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

      Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

      I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

      I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

      I apologize if these repetitions are irritating to some readers.

      Chapter 1

      Ankylosing Spondylitis

      What is Anklyosing Spondylitis?

      Ankylosing Spondylitis is a chronic medical inflammatory disorder of the joints of the spine manifested by fusion (ankylosing) and inflammation (spondylitis) of some or all of the joints and bones of the spine.

      It is a painful progressive disease involving mainly the spine.

      It can also induce inflammation of the joints between the spinal bones and the joints between the pelvis and spine.

      These joints become inflamed and fused.

      Over time the affected spinal bones join together.

      Ankylosing spondylitis (AS) is a chronic form of arthritis.

      It most commonly involves the bones and joints at the base of the spine where it joins with the pelvis.

      It can also involve other joints, tendons and ligaments.

      It can involve also other areas such as eyes, bowels, lungs, and heart.

      Who get Ankylosing Spondylitis?

      Ankylosing spondylitis (AS) is a long term seronegative spondyloarthropathy which mainly affects the axial skeleton (i.e., sacroiliitis and spondylitis).

      Every person can get Ankylosing Spondylitis.

      The age of start is normally in the late teens or early 20's.

      The disorder most often starts between ages 20 and 40 but it may occur before age 10.

      It is also more common in men than women about 3:1.

      In men the spine and pelvis are most affected.

      In women the pelvis, hips, knees, wrists and ankles are more frequent.

      Incidence

      The incidence is 0.1-2% of the general population, with the highest incidence in countries of northern Europe and the least in patients of Afro-Caribbean descent.

      The peak onset is between 20-30 years of age.

      Male to female ratio is 3:1.

      Women tend to have milder or sub-medical disease.

      Many patients with mild disease may remain undiagnosed.

      What is the cause of Ankylosing Spondylitis?

      The cause of Ankylosing Spondylitis is not known but genes seem to play a part.

      The cause is not known but involves the interaction of genetic and environmental factors.

      Inflammation happens at the insertions of the ligaments and tendons to the bone.

      The erosion of the bones happens at the site.

      When the inflammation subsides, new bone forms and replaces the elastic tissues of the ligaments or tendons.

      Fusion of bones happen leading to restriction of movement.

      It is sometimes called bamboo spine.

      This normally begins in the vertebra of the spine then involves the pelvis, then goes towards to the chest wall and neck.

      Genetics

      There is a strong familial tendency with >90% of the risk of disorder identified genetically.

      A strong link with HLA-B27 is present, particularly in white western European populations.

      About 1-2% of all people who are positive for HLA-B27 develop AS.

      This increases to 15-20% if they also have an affected first-degree relative.

      Despite much study, it is not clear how the link with HLA-B27 can find susceptibility of AS.

      In AS, the major histocompatibility complex (MHC) (a cell surface molecule encoded by a large gene family which transmits the actions of leukocytes) is responsible for nearly 50% of disease susceptibility.

      Other linked genetic factors are HLA-B60 and HLA-B39 (in HLA-B27-negative patients).

      What are the Symptoms of Ankylosing Spondylitis?

      Symptoms may be slight in early stages or mild disorder, with an insidious onset over several months to years.

      AS normally manifests before the 30 years pf age.

      Most patients have mild chronic disease or intermittent flares with periods of remission.

      Systemic signs are frequent.

      Weight loss and fever may occur during periods of active disease.

      Fatigue is also obvious.

      Morning stiffness is a typical feature.

      Inflammatory back pain:

      Often improves with moderate physical action.

      Dissimilar to mechanical back pain, patients often feel stiffness and pain which awaken them in the early morning hours.

      The spinal disease begins in the sacroiliac joints (bilateral lumbosacral region) and may be felt as diffuse nonspecific buttock pain.

      The onset is usually gradual with occasional back pain over weeks or months.

      The disease starts with low back pain that keeps recurring.

      Stiffness and pain are worse at night, in the morning or when the patient is not active.

      They may wake you from

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