Ankylosing spondylitis (AS; also known as Bechterew's disease; Bechterew syndrome; Marie Strümpell disease / Marie Struempell disease / Spondyloarthritis) is a chronic, painful, progressive inflammatory arthritis primarily affecting spine and sacroiliac joints, causing eventual fusion of the spine; it is a member of the group of the autoimmune spondyloarthropathies with a probable genetic predisposition. Complete fusion results in a complete rigidity of the spine, a condition known as bamboo spine. Image File history File linksMetadata No higher resolution available. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ... // M00-M99 - Diseases of the musculoskeletal system and connective tissue (M00-M25) Arthropathies (M00-M03) Infectious arthropathies (M00) Pyogenic arthritis (M01) Direct infections of joint in infectious and parasitic diseases classified elsewhere (M02) Reactive arthropathies (M023) Reiters disease (M03) Postinfective and reactive arthropathies in diseases classified elsewhere (M05-M14... // M00-M99 - Diseases of the musculoskeletal system and connective tissue (M00-M25) Arthropathies (M00-M03) Infectious arthropathies (M00) Pyogenic arthritis (M01) Direct infections of joint in infectious and parasitic diseases classified elsewhere (M02) Reactive arthropathies (M023) Reiters disease (M03) Postinfective and reactive arthropathies in diseases classified elsewhere (M05-M14... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Mendelian Inheritance in Man project is a database that catalogues all the known diseases with a genetic component, and - when possible - links them to the relevant genes in the human genome. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Arthritis (from Greek arthro-, joint + -itis, inflammation; plural: arthritides) is a group of conditions where there is damage caused to the joints of the body. ... The vertebral column seen from the side Different regions (curvatures) of the vertebral column The vertebral column (backbone or spine) is a column of vertebrae situated in the dorsal aspect of the abdomen. ... The sacroiliac joint is the joint between the sacrum, at the base of the spine, and the ilium of the pelvis, which are joined by ligaments. ... Autoimmune diseases arise from an overactive immune response of the body against substances and tissues normally present in the body. ... Spondyloarthropathies are a group of related inflammatory joint disease associated with the MHC class I molecule HLA-B27. ... A genetic predisposition is a genetic effect which influences the phenotype of an organism but which can be modified by the environmental conditions. ...

Signs and symptoms

The typical patient is a young man, or sometimes a woman, of 15 to 30 years of age with chronic pain and stiffness in the lower part of the spine. In 40% of cases, ankylosing spondylitis is associated with iridocyclitis (anterior uveitis, also known as iritis) causing eye pain and photophobia (increased sensitivity to light). Other common symptoms are recurring mouth ulcers (aphthae) and fatigue. In medicine, a chronic disease is a disease that is long-lasting or recurrent. ... Iridocyclitis, also known as anterior uveitis, is a condition in which the uvea of the eye suffers inflammation. ... Uveitis specifically refers to inflammation of the middle layer of the eye, termed the uvea but in common usage may refer to any inflammatory process involving the interior of the eye. ... Photophobia (also light sensitivity) or fear of light, is a symptom of excessive sensitivity to light and the aversion to sunlight or well-lit places. ... A mouth ulcer or canker sore is a painful open sore inside the mouth caused by a break in the mucous membrane. ... The word fatigue is used in everyday living to describe a range of afflictions, varying from a general state of lethargy to a specific work induced burning sensation within muscle. ...

Typical prodromes (early symptoms) may occur at a very young age (e.g. 3 years old), where the patient may experience recurring painful joints (e.g. knees, elbows), commonly misinterpreted as simple rheumatism. In medicine, a prodrome is an early symptom indicating the development of a disease, or indicating that a disease attack is imminent. ...

AS is also associated with ulcerative colitis, Crohn's disease, psoriasis, and Reiter's disease. Crohns disease (also known as regional enteritis) is a chronic, episodic, inflammatory condition of the gastrointestinal tract characterized by transmural inflammation (affecting the entire wall of the involved bowel) and skip lesions (areas of inflammation with areas of normal lining in between). ... A differential diagnosis revealed that the rash on the bottom of this individual’s feet, known as keratoderma blennorrhagica, was due to Reiters syndrome, not a syphilitic infection as was initially suspected - CDC/ Dr. M. F. Rein Reiters syndrome is the combination of three seemingly unlinked symptoms...

Diagnosis

The ankylosis process.

There is no direct test to diagnose AS. A clinical examination and X-ray studies of the spine, which show characteristic spinal changes and sacroiliitis, are the major diagnostic tools. A drawback of X-ray diagnosis is that signs and symptoms of AS have usually been established as long as 8-10 years prior to X-ray evident changes occurring on a plain film X-ray, which means a delay of as long as 10 years before adequate therapies can be introduced. An option for more accurate (and much earlier) diagnosis are tomography and magnetic resonance imaging of the sacroiliac joints. The Schober test is a useful clinical measure of flexion of the lumber spine performed during examination.^{[citation needed]} Image File history File linksMetadata Size of this preview: 598 × 599 pixelsFull resolution (1545 × 1548 pixel, file size: 343 KB, MIME type: image/jpeg) The ankylosis process, made by Senseiwa, with an image of the spine from Grays Anatomy. ... Image File history File linksMetadata Size of this preview: 598 × 599 pixelsFull resolution (1545 × 1548 pixel, file size: 343 KB, MIME type: image/jpeg) The ankylosis process, made by Senseiwa, with an image of the spine from Grays Anatomy. ... In the NATO phonetic alphabet, X-ray represents the letter X. An X-ray picture (radiograph) taken by Röntgen An X-ray is a form of electromagnetic radiation with a wavelength approximately in the range of 5 pm to 10 nanometers (corresponding to frequencies in the range 30 PHz... The sacroiliac joint is the joint between the sacrum, at the base of the spine, and the ilium of the pelvis, which are joined by ligaments. ... This article does not cite its references or sources. ... Magnetic Resonance Image showing a median sagittal cross section through a human head. ...

During acute inflammatory periods, AS patients will usually show an increase in the blood concentration of C-reactive protein (CRP) and an increase in the erythrocyte sedimentation rate (ESR). C-reactive protein (CRP) is a plasma protein, an acute phase protein produced by the liver. ... The erythrocyte sedimentation rate(ESR), also called a sedimentation rate, sed rate or Biernacki Reaction, is a non-specific measure of inflammation that is commonly used as a medical screening test. ...

Variations of the HLA-B gene increase the risk of developing ankylosing spondylitis, although it is not a diagnostic test. Those with the HLA-B27 variant are at highest risk of developing the disorder. HLA-B27, demonstrated in a blood test, is occasionally used as a diagnostic, but does not distinguish AS from other diseases and is therefore not of real diagnostic value. Over 95% of people with AS are HLA-B27 positive, although this ratio varies from population to population (only 50% of African American patients with AS possess HLA-B27, and it is close to 80% among AS patients from Mediterranean countries). Human Leukocyte Antigen B*27 (subtypes B*2701-2724) is a class I surface antigen encoded by the B locus in the major histocompatibility complex (MHC) on chromosome 6. ... Blood tests are laboratory tests done on blood to gain an appreciation of disease states and the function of organs. ...

The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), developed in Bath (UK), is an index designed to detect the inflammatory burden of active disease. The BASDA can help to establish a diagnosis of AS in the presence of other factors such as HLA-B27 positivity, persistent buttock pain which resolves with exercise, and X-ray or MRI evident involvement of the sacroiliac joints. (See: "Diagnostic Tools", below) ^[1] It can be easily calculated and accurately assesses a patient's need for additional therapy; a score of 4 out of a possible 10 points while on adequate NSAID therapy is usually considered a good candidate for biologic therapy. The BASDAI is important because it is a validated diagnostic test which allows a physician (usually a rheumatologist) to determine the effectiveness of a current drug therapy, or the need to institute a new drug therapy for the treatment of ankylosing spondylitis. ... Bath is a city in South West England most famous for its baths fed by three hot springs. ...

The Bath Ankylosing Spondylitis Functional Index (BASFI) is a functional index which can accurately assess a patient's functional impairment due to the disease, as well as improvements following therapy. (See: "Diagnostic Tools", below) ^[2] The BASFI is not usually used as a diagnostic tool, but as a tool to establish a patient's current baseline and subsequent response to therapy.

Pathophysiology

AS is a systemic rheumatic disease, and is one of the seronegative spondyloarthropathies. About 90% of the patients express the HLA-B27 genotype. Tumor necrosis factor alpha (TNF α) and IL-1 are also implicated in ankylosing spondylitis. Although specific autoantibodies cannot be detected, its response to immunosuppresive medication has prompted its classification as an autoimmune disease. Rheumatology, a subspecialty of internal medicine, is devoted to the diagnosis and treatment of rheumatic diseases. ... SpA redirects here. ... Human Leukocyte Antigen B*27 (subtypes B*2701-2724) is a class I surface antigen encoded by the B locus in the major histocompatibility complex (MHC) on chromosome 6. ... In medicine, tumor necrosis factor alpha (TNFα, cachexin or cachectin) is an important cytokine involved in systemic inflammation and the acute phase response. ... Interleukin-1 (IL-1) is secreted by the macrophages, monocytes and dendritic cells. ...

Hypotheses on its pathogenesis include a cross-reaction with antigens of the Klebsiella bacterial strain (Tiwana et al. 2001).^[3] Particular authorities argue that elimination of the prime nutrients of Klebsiella (starches) would decrease antigenemia and improve the musculoskeletal symptoms. On the other hand, Khan (2002) argues that the evidence for a correlation between Klebsiella and AS is circumstantial so far, and that the efficacy of low-starch diets has not yet been scientifically evaluated.^[4] Similarly, Toivanen (1999) found no support for the role of klebsiella in the etiology of primary AS.^[5] Klebsiella pneumoniae is a gram-negative rod-shaped bacteria, and clinically the most important member of the Klebsiella genus of Enterobacteriaceae. ...

Epidemiology

The sex ratio is 3:1 for men:women. In the USA, the prevalence is 0.25%, but as it is a chronic condition the incidence (number of new cases) is fairly low. In epidemiology, the prevalence of a disease in a statistical population is defined as the ratio of the number of cases of a disease present in a statistical population at a specified time and the number of individuals in the population at that specified time. ... The incidence of disease is defined as the number of new cases of disease occurring in a population during a defined time interval. ...

History

Leonard Trask the Wonderful Invalid.

AS was probably first recognized as a disease which was different from Rheumatoid Arthritis by Galen as early as the second century AD^{[citation needed]}; however, skeletal evidence of the disease (ossification of joints and entheses primarily of the axial skeleton, known as "bamboo spine") were first discovered in an archaeological dig that unearthed the skeletal remains of a 5000 year–old Egyptian mummy with evidence of "bamboo spine".^[6] Image File history File links Download high-resolution version (542x783, 76 KB) Summary This is from an edition I own. ... Image File history File links Download high-resolution version (542x783, 76 KB) Summary This is from an edition I own. ... Rheumatoid arthritis (RA) is traditionally considered a chronic, inflammatory autoimmune disorder that causes the immune system to attack the joints. ... Galen (Greek: Γαληνός, Galinos; Latin: Claudius Galenus; AD 129 –c. ... The axial skeleton consists of the bones in the head and trunk of a vertebrate body. ...

The anatomist and surgeon Realdo Colombo described what could have been the disease in 1559,^[7] and the first account of pathologic changes to the skeleton possibly associated with AS was published in 1691 by Bernard Connor.^[8] In 1818, Benjamin Brodie became the first physician to document that iritis accompanied what is believed to have been a patient with active AS.^[9] In 1858, David Tucker published a small booklet which clearly described a patient by the name of Leonard Trask who suffered from severe spinal deformity subsequent to AS.^[10][11] In 1833 Trask fell from a horse, exacerbating the condition and resulting in severe deformity. Tucker reported that Matteo Realdo Colombo or Renaldus Columbus (c. ... This article or section does not cite any references or sources. ... Sir Benjamin Collins Brodie, 1st Bart. ... Iritis is a form of anterior uveitis and refers to the inflammation of the iris of the eye. ...

evidence of inflammatory disease characteristics of AS, and the hallmark of deforming injury in AS. This account became the first documented case of AS in the United States.

It was not until the late nineteenth century (1893-1898), however, when the neurophysiologist Vladimir Bekhterev of Russia in 1893,^[12] Adolph Strümpell of Germany in 1897,^[13] and Pierre Marie of France in 1898,^[14] were the first to give adequate descriptions which permitted an accurate diagnosis of AS prior to severe spinal deformity. For this reason, AS is also known as Bechterew Disease or Marie–Strümpel Disease. Neurophysiology is a part of physiology as a science, which is concerned with the study of the nervous system. ... Vladimir Bekhterev (January 20, 1857 – December 24, 1927) was a Russian neurophysiologist and psychiatrist who noted the role of the hippocampus in memory around 1900. ... Adolph Strümpell (1853-1925); full name Ernst Adolf Gustav Gottfried von Strümpell was a German neurologist and educator whose medical career was spent in several European cities, including Leipzig, Erlangen and Heidelberg. ... Pierre Marie (born September 9, 1853, died April 13. ...

Prognosis

AS can range from mild to progressively debilitating, and from medically controlled to refractive.

Unattended cases of AS normally lead to knee pain, and may be accompanied by dactylitis or enthesitis, which may result in a misdiagnosis of normal rheumatism. In a long-term undiagnosed period, osteopenia or osteoporosis of AP spine may occur, causing eventual compression fractures and a back "hump" if untreated. Typical signs of progressed AS are the visible formation of syndesmophytes on X-rays, an abnormal bone outgrowth similar to osteophytes, affecting the spine. Due to the fusion of the vertrbrae paresthesia is a complication due to the inflammation of the tissue surrounding nerves. Dactylytis is a sausage-shaped swelling of the fingers and toes, and can be painful. ... Enthesitis is an inflammation of the entheses. ... Osteopenia is a decrease in bone mineral density that can be a precursor condition to osteoporosis. ... Osteoporosis is a disease of bone in which the bone mineral density (BMD) is reduced, bone microarchitecture is disrupted, and the amount and variety of non-collagenous proteins in bone is altered. ... Paresthesia or paraesthesia (in British English) is a sensation of tingling, pricking, or numbness of a persons skin with no apparent long-term physical effect, more generally known as the feeling of pins and needles or of a limb being asleep. // Transient paresthesia is the temporary sensation of tingling...

Organs affected by AS, other than the axial spine and other joints, are commonly the heart, lungs, colon, and kidney. Other complications are Aortic regurgitation^{[citation needed]}, Achilles tendonitis, AV node block^{[citation needed]} and Amyloidosis^{[citation needed]}. Due to lung fibrosis^{[citation needed]}, chest X-rays may show apical fibrosis while pulmonary function testing may reveal a restrictive lung defect. The vertebral column seen from the side Different regions (curvatures) of the vertebral column The vertebral column (backbone or spine) is a column of vertebrae situated in the dorsal aspect of the abdomen. ... The heart and lungs, from an older edition of Grays Anatomy. ... Respiratory system The lungs flank the heart and great vessels in the chest cavity. ... For the article about the punctuation symbol, see Colon (punctuation). ... It has been suggested that Renal anomalies and Renal plasma threshold be merged into this article or section. ... Aortic insufficiency (AI), also known as aortic regurgitation (AR), is the leaking of the aortic valve of the heart that causes blood to flow in the reverse direction during ventricular diastole, from the aorta into the left ventricle. ... Achilles tendonitis is an inflammation of the Achilles tendon (see Tendonitis). ... A heart block is a disease in the electrical system of the heart. ... Image A: A normal chest X-ray. ... Spirometry, also known as Pulmonary Function Testing (PFT), is the measurement of lung function, specifically by measuring the volume and speed of air that can be inhaled and exhaled. ...

Very rare complications involve neurologic conditions such as the cauda equina syndrome ^[15]. Neurology is a branch of medicine dealing with disorders of the nervous system. ... Cauda equina syndrome is a serious neurologic condition in which there is compression of the vertebral column (spine) affecting the S1-S4 nerve roots. ...

Therapy

No cure is known for AS, although treatments and medications are available to reduce symptoms and pain.

Physical therapy and exercise, along with medication, are at the heart of therapy for ankylosing spondylitis. Physiotherapy and physical exercises are clearly preceded by medical treatment in order to reduce the inflammation and pain, and commonly followed by a physician. This way the movements will help in diminishing pain and stiffness, while exercises in an active inflammatory state will just make the pain worse.

Patients who are able to do so, lie flat on their face or back on the floor for a prescribed cumulative period of time each week, to prevent the chronic stooping which may otherwise result.^[16]

Medication

There are three major types of medications used to treat ankylosing spondylitis.

• NSAIDs such as aspirin, ibuprofen, indometacin, naproxen and COX-2 inhibitors, which reduce inflammation and pain. These drugs tend to have a personal response to the pain and inflammation, although commonly used anti-inflammatory drugs like nimesulide are less effective than others;
• DMARDs such as cyclosporin, methotrexate, sulfasalazine, and corticosteroids, used to reduce the immune system response through immunosuppression;
• TNFα blockers (antagonists) such as etanercept, infliximab and adalimumab (also known as biologics), are indicated for the treatment of and are effective immunosuppressants in AS as in other autoimmune diseases;

TNFα blockers have been shown to be the best promising treatment, slowing the progress of AS in the majority of clinical cases. They have also been shown to be highly effective in treating not only the arthritis of the joints but the spinal arthritis associated with AS. A drawback is the fact that these drugs increase the risk of infections. For this reason, the protocol for any of the TNF-α blockers include a test for tubercolosis (like Mantoux or Heaf) before starting treatment. In case of recurrent infections, like even recurrent sore throats, the therapy may be suspended due to the involved immunosuppression. Non-steroidal anti-inflammatory drugs, usually abbreviated to NSAIDs, are drugs with analgesic, antipyretic and anti-inflammatory effects - they reduce pain, fever and inflammation. ... Aspirin or acetylsalicylic acid (acetosal) is a drug in the family of salicylates, often used as an analgesic (against minor pains and aches), antipyretic (against fever), and anti-inflammatory. ... Ibuprofen (INN) (IPA: ) is a non-steroidal anti-inflammatory drug (NSAIDs) originally marketed as Nurofen and since under various trademarks including Act-3, Advil, Brufen, Dorival, Herron Blue, Panafen, Motrin, Nuprin and Ipren or Ibumetin (Sweden), Ibuprom (Poland), Moment (Italy). ... Indomethacin is an indole derived non-steroidal anti-inflammatory drug. ... Naproxen (trade names: Aleve, Anaprox, Naprogesic, Naprosyn, Naprelan) is a non-steroidal anti-inflammatory drug (NSAID) commonly used for the reduction of mild to moderate pain, fever, inflammation and stiffness caused by conditions such as osteoarthritis, rheumatoid arthritis, psoriatic arthritis, gout, ankylosing spondylitis, injury, menstrual cramps, tendinitis, bursitis, and the... COX-2 selective inhibitor is a form of Non-steroidal anti-inflammatory drug (NSAID) that directly targets COX-2, an enzyme responsible for inflammation and pain. ... Nimesulide structure formula Nimesulide is a prescription non-steroidal anti-inflammatory drug (NSAID) with analgesic and antipyretic properties. ... Disease-modifying antirheumatic drugs is a category of drugs used in many autoimmune diseases to slow down disease progression. ... ... Methotrexate (rINN) (IPA: ), abbreviated MTX and formerly known as amethopterin, is an antimetabolite drug used in treatment of cancer and autoimmune diseases. ... Sulfasalazine is a sulfa drug, a derivative of Mesalazine (5-aminosalicylic acid abbreviated as 5-ASA), used primarily as an anti-inflammatory agent in the treatment of inflammatory bowel disease as well as for rheumatoid arthritis. ... In physiology, corticosteroids are a class of steroid hormones that are produced in the adrenal cortex. ... Immunosuppression is the medical suppression of the immune system. ... In medicine, tumor necrosis factor alpha (TNFα, cachexin or cachectin) is an important cytokine involved in systemic inflammation and the acute phase response. ... This article refers to literary antagonists. ... Etanercept (Enbrel®, co-marketed by Amgen and Wyeth) is a human recombinant, soluble tumor necrosis factor-alpha (TNFα) receptor. ... Infliximab (brand name Remicade®) is a drug used to treat auto-immune disorders. ... Adalimumab (Humira®) is the third TNF antagonist (after infliximab and etanercept) to be approved in the US. Like infliximab and etanercept, adalimumab binds to TNFα, preventing it from activating TNF receptors; adalimumab was constructed from a fully human monoclonal antibody, while infliximab is a mouse-human chimeric antibody and etanercept... Immunosuppression is the medical suppression of the immune system. ... In medicine, tumor necrosis factor alpha (TNFα, cachexin or cachectin) is an important cytokine involved in systemic inflammation and the acute phase response. ... Tuberculosis (commonly shortened to TB) is an infection caused by the bacterium Mycobacterium tuberculosis, which most commonly affects the lungs (pulmonary TB) but can also affect the central nervous system (meningitis), lymphatic system, circulatory system (Miliary tuberculosis), genitourinary system, bones and joints. ... This does not cite any references or sources. ... The Heaf test is a diagnostic skin test performed in order to determine whether or not a child has been exposed to tuberculosis. ... Pharyngitis (far-in-jÄ« tis) is a painful inflammation of the pharynx, and is colloquially referred to as a sore throat. ... Immunosuppression is the medical suppression of the immune system. ...

Surgery

In severe cases of AS, surgery can be an option in the form of joint replacements, particularly in the knees and hips. Surgical correction is also possible for those with severe flexion deformities (severe downward curvature) of the spine, particularly in the neck, although this procedure is considered risky. A cardiothoracic surgeon performs a mitral valve replacement at the Fitzsimons Army Medical Center. ...

Physical therapy

All physical therapies must be approved in advance by a rheumatologist, since movements that normally have great benefits on one's health, may harm a patient with AS: massages and physical manipulations should be practiced by therapists familiar with this disease.

• Physical therapy has been shown to be of great benefit to AS patients;
• Swimming is one of the preferred exercises since it involves all muscles and joints in a low gravity environment;
• Slow movements exercises like stretching, yoga, tai chi;
• Any physical movement like, jogging, Pilates method, etc.

Physical therapy (or physiotherapy[1]) is the provision of services to people and populations to develop, maintain and restore maximum movement and functional ability throughout the lifespan. ... This article concentrates on human swimming. ... An actively stretching Siberian tiger Cat stretching in utterly relaxed position Definition Stretching as theorized in literature is the result of movement, applied by an external and/or internal force, in order to increase muscle flexibility and/or joint range of motion (Weerapong et al 189-206). ... Statue of Shiva performing Yogic meditation Yoga (Devanagari: योग) is a Sanskrit word that has a wide range of different meanings. ... Tai Chi Chuan or Taijiquan (from Chinese 太极拳 Tàijíquán, literally supreme ultimate fist), commonly known as Tai Chi or Taiji, is a nei chia (internal) Chinese martial art which is known for the claims of health and longevity benefits made by its... Jogging is a form of trotting or running at a slow or leisurely pace. ... The Pilates Method (sometimes simply Pilates) (IPA: //) is a physical fitness system that was developed in the early 20th century by Joseph Pilates. ...

Alternative medicine

Although the effectiveness of alternative medicines has not been proved by any clinical trial, some patients find some relief in adding these alternative treatments to the medicaments and physical exercises, like a starch free diet^[17] Patients can find relief under acupuncture treatments and herbal medicine. It can be treated by the use of various points directly on the spine where the pain is located. Herbal medicine, when correctly formulated by a doctor, may also treat by relieving pain, reducing inflammation, and providing natural supplements to strengthen the body's bones, muscles, and tendons.^{[citation needed]} In medicine, a clinical trial (synonyms: clinical studies, research protocols, medical research) is the application of the scientific method to human health. ... Starch (CAS# 9005-25-8) is a complex carbohydrate which is soluble in water; it is used by plants as a way to store excess glucose. ... In nutrition, the diet is the sum of food consumed by a person or other organism. ...

Famous patients

Well known sufferers of AS include:

• Mötley Crüe guitarist Mick Mars;
• Former England cricket captain Mike Atherton;
• Former Australian cricketer Michael Slater;
• British comedian Lee Hurst;
• Canadian radio personality Mike Stafford;
• Norwegian Prime Minister Jens Stoltenberg;
• World Chess Champion Vladimir Kramnik;
• Former author and "Saturday Review" editor Norman Cousins;^[18]
• Scottish former snooker player Chris Small;
• Former US Major League baseball player Rico Brogna;
• Ed Sullivan, the Ed Sullivan Show, US;
• Taiwanese musician Jay Chou;
• Czech writer Karel Čapek^[19].

Mötley Crüe (IPA pronunciation: ) is a popular American glam metal band from Los Angeles, California. ... Mick Mars (born Bob Alan Deal, May 4, 1951 in Terre Haute, Indiana) is the guitar player for heavy metal band Mötley Crüe. ... For the insect, see Cricket (insect). ... Michael Andrew Atherton (born March 23, 1968, in Failsworth, near Oldham, in Lancashire) is a broadcaster, journalist and retired cricket player. ... Michael Jonathon Slater (born February 21, 1970, Wagga Wagga, New South Wales) is a former Australian cricketer who played in 74 Tests and 42 ODIs from 1993 to 2001. ... Lee Hurst is a comedian who runs his own club, Lee Hursts Backyard Comedy club, in Londons East End. ... Jens Stoltenberg (born March 16, 1959) is a Norwegian economist, leader (since 2002) of the Norwegian Labour Party and the current Prime Minister of Norway. ... Vladimir Borisovich Kramnik (Russian: ) (born June 25, 1975) is a Russian chess grandmaster and the current undisputed World Chess Champion. ... Norman Cousins in 1976. ... Chris Small (born 26 September 1973) is a Scottish professional snooker player. ... Rico Joseph Brogna (born April 18, 1970 in Turners Falls, Massachusetts) is a former professional baseball player who played in the Major Leagues, primarily as a first baseman, in 1992 and from 1994-2001. ... This article includes a list of works cited but its sources remain unclear because it lacks in-text citations. ... Jay Chou (Traditional Chinese: ; Simplified Chinese: ; Hanyu Pinyin: Zhōu Jiélún; Wade-Giles: Chou Chieh-lun; Pe̍h-ōe-jī: Chiu Kia̍t-lûn), born 18 January 1979, is a World Music Award-winning, arguably one of the most successful and influential Taiwanese musician, singer, and producer. ... Karel Čapek (pronounced ; IPA: ) (January 9, 1890 - December 25, 1938) was one of the most important Czech writers of the 20th century. ...

See also

• NASC, the AS patients' federation
• NIAMS, the National Institute of Arthritis and Musculoskeletal and Skin Diseases

North American Spondylitis Consortium, or NASC is an NIH funded AS Family Genetic Project funded through the University of Texas Health Science Centre, Houston. ... NIAMS, the United States National Institute of Arthritis and Musculoskeletal and Skin Diseases, is a division of the National Institutes of Health. ...

Footnotes

2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the CE era. ... January 11 is the 11th day of the year in the Gregorian calendar. ...

External links

National organizations

• The Ankylosing Spondylitis group (Australia)
• Vlaamse Vereniging voor Bechterew-Patiënten vzw (Belgium)
• Associazione Italiana per la Lotta alla Spondilite Anchilsante (Italy)
• National Ankylosing Spondylitis Society (UK)
• Spondylitis Association of America (USA)

Diagnostic tools

• Bath Ankylosing Spondylitis Disease Activity Index Calculator (BASDAI)
• Bath Ankylosing Spondylitis Functional Index Calculator (BASFI)

Support groups

• KickAS.org (online community; support and information)

Current research

• Ankylosing Spondylitis Research Recent primary literature
• Ankylosing Spondylitis Information Matrix Muhammad A. Khan, MD