[Click! Health] May 6 is 'World Ankylosing Spondylitis Day'... High Incidence Among Young Men

May 6th is 'World Ankylosing Spondylitis Day.' Ankylosing spondylitis, which causes the spinal joints to stiffen, is the most common disease among 'seronegative spondyloarthropathies' where rheumatoid factors are negative. It is a chronic inflammatory disease that characteristically affects the sacroiliac joints of the hips and the spinal joints. According to the Health Insurance Review and Assessment Service, the number of patients visiting hospitals for ankylosing spondylitis (disease code M45) increased by 22% over five years, from 41,797 in 2017 to 51,106 in 2021. Male patients were 2.5 times more than female patients, and especially those in their 20s to 40s accounted for 56%, indicating a high incidence among young men.

If left untreated, ankylosing spondylitis causes the back to become hunched and the neck to stiffen. The initial representative symptom is pain in the hip bones, which is easy to overlook, so many patients visit hospitals only after the inflammation has already spread to the thoracic spine. The stiffened areas are difficult to recover, so early detection and treatment are effective.

Professor Sang-Hoon Lee, Department of Rheumatology, Gangdong Kyung Hee University Hospital.

A research team led by Professor Lee Sang-hoon of the Department of Rheumatology at Gangdong Kyung Hee University Hospital conducted a study on 1,170 patients diagnosed with ankylosing spondylitis who underwent spinal CT scans between 2008 and 2015. Among them, 79% (920 patients) were male, and the average age was 33±10 years. Notably, 47.2% had already experienced thoracic spine involvement at the time of diagnosis. Professor Lee emphasized, "Ankylosing spondylitis generally begins to affect the spine with alternating pain in both hip bones. If diagnosis is missed during this period, symptoms may not be severe until the thoracic spine is involved, which can delay diagnosis."

When ankylosing spondylitis affects the thoracic spine, patients experience chest pain even with mild coughing and pain when pressing with their hands. Additionally, symptoms such as waking up due to lower back pain during sleep persist for more than three months. Therefore, if these symptoms are present, ankylosing spondylitis should be suspected and medical consultation should be sought promptly. If chest pain is reported, a basic chest X-ray is usually performed, but this alone makes it difficult to determine thoracic spine involvement in ankylosing spondylitis because the lungs' air obscures the view. Instead, CT scans are used to check for abnormalities in the thoracic spine and differentiate ankylosing spondylitis.

When ankylosing spondylitis is detected early, combining medication and exercise therapy can prevent the progression of spinal stiffness, making it a disease that does not significantly interfere with daily life. However, because pain occurs intermittently and is easily relieved by painkillers, early diagnosis is often missed. If patients visit hospitals after spinal stiffness has progressed to the thoracic spine, treatment outcomes cannot be optimistic, as once joints have stiffened, recovery is impossible. Therefore, it is crucial to recognize symptoms early and start treatment promptly. Professor Lee explained, "Due to the effectiveness of medication, only about 10% progress to stiffness, but if diagnosis is delayed until thoracic spine involvement is detected, treatment effectiveness can be greatly reduced. If symptoms suggestive of ankylosing spondylitis appear, do not delay and consult a specialist."

① The spine is stiff in the morning, making it difficult to bend the head down, but improves with movement.
② Lower back pain subsides completely after taking anti-inflammatory painkillers.
③ Intermittent hip pain causes limping.
④ There has been swelling in the knees or ankles of unknown cause.

This content was produced with the assistance of AI translation services.