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Normally, osteoarthritis doesn’t cause inflammation in the joints. But there’s a type of arthritis called spondyloarthritis, which is a catch-all term for a group of joint diseases that do cause inflammation. Interestingly, unlike osteoarthritis, spondyloarthritis often attacks young adolescent and post-adolescent men.
Most people who suffer from spondyloarthritis suffer pain in their lower back, especially if they have a type of the condition called axial spondyloarthritis. They also suffer from painful swelling of their limbs if they have peripheral spondyloarthritis. The inflammation sets up in the areas where the tendons and the ligaments of the body connect to the sufferer’s bones. The bones themselves can be affected to the point where they fuse together. Over time, the patient can suffer from a pronounced curvature of his spine.
One type of spondyloarthritis is inherited. This is called ankylosing spondylitis and the culprit is a gene called the HLA-B27.
If it’s untreated, spondyloarthritis damages more than the bones and cartilage. It can increase a person’s risk of osteoporosis. This is where the bone loses density to the point where ordinary activity can cause fractures. Spondyloarthritis can also lead to inflammation in the eye, the aortic valve and the intestines. The person might also be more at risk for psoriasis, which is a skin disease.
Spondyloarthritis can be diagnosed through X-rays, the patient’s medical history and through a physical examination. Blood tests might also help the physician diagnose the condition. If X-rays are inconclusive, the doctor might also order an MRI.
Patients are often prescribed NSAIDs, like ibuprofen, to treat the pain of the condition. However, NSAIDS have quite negative long term side effects. The US reports more deaths from long term NSAID use than AIDS or cervical cancer.
In other cases, the patient might be treated with injections of corticosteroids that can also reduce the inflammation and relieve the pain. If these two lines of treatment don’t work, the patient might be given DMARDs, or disease modifying anti-rheumatic drugs, that also reduce the inflammation and guard against bone damage. The patient can also be placed on a course of TNF alpha blockers. However, these drugs are known to have sometimes serious side effects. They can put a patient at greater risk for sometimes life-threatening infections and cause symptoms in patients who have asymptomatic tuberculosis.
Surgery is done as a last resort for patients who have extensive destruction of their bone and cartilage. The most common surgery for a person with a devastating case of spondyloarthritis is a total hip replacement.
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