In ankylosing spondylitis (synonyms: ankylosing arthritis of the spine; ankylosing spondylitis (AS); respiratory disease in ankylosing spondylitis; Graves’ disease; iridocyclitis in ankylosing spondylitis; Marie-Pierre disease; Marie-Strümpell spondylitis; Marie-von-Strümpell arthritis of the spine; Marie-von-Strümpell disease; primary progressive spinal arthritis; rheumatoid spondylitis; rheumatoid arthritis of the spine; Ankylosing spondylarthritis; ankylosing spondylitis; ankylosing spondylitis; ankylosing spondylitis with pulmonary involvement; spondylitis atrophica ligamentosa; spondylitis in chronic polyarthritis; spondylitis rhizomélique; Spondylosis rhizomélique; Strümpfel-Marie-Bechterew disease; Von Bechterew disease; Von Bechterew syndrome; Von Bechterew von Strümpell-Marie disease; Von Bechterew von Strümpell-Marie syndrome; ICD-10-GM M45. 09: Ankylosing spondylitis: unspecified location) is a chronic inflammatory disease of the spine that can lead to joint stiffness (ankylosis) of the affected joints. The sacroiliac joints (ISG; sacroiliac joints) are typically affected first.
The disease belongs to the group of seronegative spondyloarthritides (SpA; synonym: seronegative spondyloarthropathy), in which inflammation of the small vertebral joints (spondylarthritis) is present. These diseases are distinguished from chronic polyarthritis by the absence of rheumatoid factors (= seronegative).
Bekhterev’s disease (ankylosing spondylitis) is the main representative of the predominant axial spondyloarthitides (axial spondyloarthritis, (axSpa)).
Sex ratio: males to females is 3: 1.
Peak incidence: the disease usually manifests between the ages of 20 and 40.
The prevalence (disease incidence) is 0.15% in Germany and up to 1% in Europe. The number of unreported cases could be considerably higher. In Germany, the disease is currently diagnosed in about 150,000 people.
Course and prognosis: The disease progresses inconsistently and usually in relapses. For the most part, the disease manifests itself only in the spine. On the other hand, peripheral joints (joints of the limbs) or internal organs may also be affected. Complete ankylosis (bony stiffening) of the spine is very rare, so that affected persons suffer from restrictions in mobility but can remain employed. Sometimes the courses can be so mild that the disease remains undetected. In women, the course of the disease is often milder. A cure for the disease is not possible, but with adequate pharmacotherapy (drug therapy) and physiotherapy, the course can be positively influenced.
Comorbidities (concomitant diseases): cardiovascular disease (heart and vascular disease) and changes in bone density (osteopenia (reduction in bone density)/osteoporosis (bone loss)).
