What Is Ankylosis?

Tonicity, disease name. Mostly refers to the stiffness of a muscle in the body. "Ask to ask the truth": "Various rigidity belongs to the wind." Stiffness is particularly common in the neck, and can also be expressed in the muscles around the body. "The Nei Jing Zhi Yao · Sheng Neng": "Strong, strong tendons; straight, straight and unable to bend and stretch." More common in diseases such as spasm, epilepsy, and tetanus. See also spasms, epilepsy, etc.

[qiáng zhí]

Tonicity, disease name. Mostly refers to the stiffness of a muscle in the body. "Ask to ask the truth": "Various rigidity belongs to the wind." Stiffness is particularly common in the neck, and can also be expressed in the muscles around the body. "The Nei Jing Zhi Yao · Sheng Neng": "Strong, strong tendons; straight, straight and unable to bend and stretch." More common in diseases such as spasm, epilepsy, and tetanus. See also spasms, epilepsy, etc.

Chinese name

Rigidity

Zhuyin

Definition

Finger stiffness

Also

Rigidity

Word: rigidity

Pinyin: qiáng zhí

Phonetic : ^[1]

1. [tetanus]: Disturbance due to a continuous motion impulse

1. Tonic: Also known as "tonicity". Also called "strong planting".

1. Strong and upright. "Thirty Years of Zuo Xianggong": "Zi Chan said: 'Is it my apprentice? Who knows the calamity of the country?

(1) The majority of ankylosing spondylitis with systemic symptoms occur in adolescence, and the onset is often hidden; it is rare for people over 40 years of age to develop it. Lesions develop slowly in women, often with delayed diagnosis. Ankylosing spondylitis is a systemic disease with systemic symptoms such as anorexia, low fever, fatigue, weight loss, and mild anemia.

(Two) local performance

1. Low back pain and spinal stiffness are the most common manifestations. Low back pain occurs slowly and dull, and it is unclear where the pain is, sometimes involving the buttocks. It can also be very painful, concentrated near the sacroiliac joint, and radiated to the sacroiliac, the greater trochanter and the back of the femur. At the beginning, the pain is either bilateral or unilateral, but it becomes bilateral after a few months. And appeared stiff lower waist. Morning stiffness is a very common symptom that can last for hours. Stiffness is more pronounced due to long periods of inactivity. Patients often complain that it is difficult to get up because of stiffness and pain. They can only turn over to the side and roll off the edge of the bed to stand up.

In some patients, the pain is mild. Only morning stiffness and tender points in the lumbar muscle ligaments are often diagnosed as "rheumatic pain", "fibrositis", or even "neuropathy". Radiation pain in the legs has long been diagnosed as "lumbar and leg pain" and "sciatica."

There are not many signs in the early stage, and there may be mild restriction of lumbar spine, but it can only be detected when hyperextension or lateral flexion. There may be tenderness at the sacroiliac joint, but it is generally not serious. As the lesion progresses, the sacroiliac joint is ankylosing. At this time, the site can be completely painless, and spinal stiffness becomes one of the main signs. Patients can keep their knees in an upright position and touch their fingertips to the floor. This does not mean that there is no movement disorder in the waist, because a good hip joint can completely compensate. To check for spinal rigidity, a thorough examination of spinal overextension, lateral flexion, and rotation should be performed. The following method (Schober test) is helpful: when the patient is in an upright position, make a mark on the 5th lumbar spinous process, and then make a second mark on the midline of the spine 10 cm away from the mark. Instruct the patient to bend the spine as far as possible and keep the knee joint fully extended. Under normal circumstances, the distance between the two points can be increased by more than 5cm, which can reach more than 15cm. An increase of less than 4cm can be considered as a decrease in lumbar spine activity.

As the lesion continues to develop, thoracic kyphosis and the onset of cervical spine will occur. The diagnosis is easier at this time. The patient was standing against the wall, his pillow could not touch the wall, and severe humpback deformity could be caused. The patient could not look up with his eyes. He could only compensate by flexing his hips and knees. As for the neck manifestations, the onset is generally late; there are also those that are limited to the development of the thoracic segment and no longer extend upward. A small number of patients develop neck symptoms at an early stage and quickly stiffen at the neck flexion position.

2. Diminished thoracic expansion as the lesions progressed to the thoracic spine and the rib-spine joints were involved. At this time, chest pain and radiation intercostal neuralgia occurred. Only a few patients noticed that the rib cage did not expand sufficiently when inhaled. Due to the rigidity of the rib and spine joints, during examination, it can be found that the chest cannot move during inhalation and can only rely on the diaphragm to breathe. Under normal circumstances, the maximum inhalation and exhalation, the mobility at the fourth intercostal space can reach more than 5cm. Those less than 5cm should be considered as diminished thoracic expansion. Early lung function is rarely weakened. At the later stage, due to severe kyphosis and loss of thoracic expansion ability, the pulmonary ventilation function was significantly reduced.

3 Ankylosing spondylitis with 35% of peripheral major arthritis may have peripheral arthritis, with hip joints being the most common. Usually bilateral, with slow onset, flexion contractures and rigidity soon appear. To maintain an upright position, compensatory flexion of the knee is often present. The shoulder joint is the second most common site. Occasionally knee lesions. Other joints are rare.

4 Exoskeleton tenderness mainly occurs at the junction of the sternum and ribs, spinous processes, condyles, femoral trochanter, tibial tuberosity, ischial tuberosity, and heel. Sometimes these symptoms can also appear early.

5. Extraskeletal lesions are mainly ocular lesions, which may have acute uveitis, with an incidence of up to 25%. Cardiovascular diseases include aortic inflammation, aortic insufficiency, enlarged heart, atrioventricular block and pericarditis. Pulmonary lesions are mainly progressive fibrosis of the upper lobe. Neurological lesions are often secondary, with spontaneous suboccipital subluxation of the atlantooccipital joint and compression of the cauda equina. The latter manifests as dysuria and numbness in the perineum saddle.

Therefore, patients with ankylosing spondylitis should be treated differently according to different symptoms, and do not miss the optimal treatment time. Avoid unnecessary injuries.

Multifunctional treatment for ankylosing spondylitis

Ankylosing spondylitis is a chronic and persistent disease in medicine. It is characterized by inflammation and ossification of the spinal joints and ligaments of the lumbar, cervical, and thoracic spine, as well as sacroiliac joints. The hip joints are often affected, and inflammation can also occur in other peripheral joints . The onset of this disease is insidious, with slow progress and mild systemic symptoms. In the early stage, there are often low back pain and stiffness in the morning, which is reduced after exercise, and may be accompanied by symptoms such as low fever, fatigue, loss of appetite, and weight loss. The pain was intermittent at the beginning, and developed into persistence after a few months and years. After that, the inflammatory pain disappeared, and the spine was partially or completely rigid from the bottom to the top, and kyphosis appeared. Involvement of peripheral joints in female patients is more common, progress is slower, and spinal deformities are milder. Because ankylosing spondylitis is a relatively common disease, its course is lingering, and it is easy to cause disability. Therefore, early diagnosis and early treatment should be sought. For young people aged 16-25, especially young men, if the following symptoms occur, special attention should be paid to the possibility of ankylosing spondylitis.

Ankylosing spondylitis is generally insidious, without any clinical symptoms at an early stage, and some patients may show mild systemic symptoms at an early stage, such as fatigue, weight loss, chronic or intermittent hypothermia, anorexia, and mild anemia. Because the condition is relatively mild, most of the patients cannot be detected early, resulting in delay of the condition and loss of the best opportunity for treatment. The purpose of treatment is to control inflammation, reduce or relieve symptoms, maintain normal posture and optimal functional position, and prevent deformities. In fact, if patients with compulsive spondylitis can be diagnosed and treated in a timely manner, they can control the symptoms, improve the prognosis, and look forward to recovery. Through non-drug, drug, alternative medicine, surgery and other comprehensive treatments, it can relieve pain and stiffness, control or reduce inflammation, maintain a good posture, prevent spine or joint deformation, and correct deformed joints if necessary to improve and improve patients. Purpose of quality of life.

medical treatement

(1) General drugs

Including non-steroidal anti-inflammatory drugs, sulfasalazine, methotrexate, leflunomide, glucocorticoids, thalidomide (Talidomide), traditional Chinese medicine and so on.

(B) Biological agents

Including Etanercept, Infliximab, Adalimumab, etc.

Surgical treatment

Ankylosing spondylitis is mostly caused by the involvement of the hip and sacroiliac joints. Joint space narrowing (degeneration of cartilage wear), ankylosis (calcification of cartilage) and deformities are the main causes of disability. For patients with apparently narrow hip joint space or necrotic deformation of the femoral head, in order to improve the joint function and quality of life of the patient, artificial total hip replacement can be considered. After replacement, the joint pain of most patients is controlled, and the function of some patients returns to normal or close to normal, and the life of the joint is 90% or more than 10 years. For severe spinal flexion or scoliosis that leads to obvious life disorders, such as: the road a few meters ahead cannot be seen when walking, such patients can consider spinal vertebral osteotomy to correct the deformity, but this type of surgery is riskier and may Damage to the spinal cord leads to paraplegia of the lower limbs. Therefore, surgical correction is not recommended for patients with spinal deformities that are not very serious. Physical rehabilitation should be performed under active medical treatment, which can also slow down or inhibit the development of deformities to a certain extent.

Non-drug therapy

1. Actively participate in the treatment and cooperate with the physician to maintain a happy and relaxed mental state.

2. Exercise with caution and uninterrupted in order to obtain and maintain the best position of the spine joints, strengthen the paravertebral muscles and increase the vital capacity, which is no less important than drug treatment.

3. When standing, try to keep your chest straight, abdomen, and eyes straight ahead. The sitting position should also keep the chest upright. Should sleep on a hard bed, take more supine position, to avoid the position of promoting deformity. Pillows should be short. Once there is involvement of the upper chest or cervical spine, the pillows should be discontinued. You can wear a waist supporter or a strap to help your body correct.

4. Reduce or avoid physical activity that causes persistent pain.

5. Select necessary physical treatment for pain of inflammatory joints or other soft tissues.

Four principles for patients with ankylosing spondylitis

Early detection

Patients with suspected ankylosing spondylitis, or friends with a family genetic history, should go to the hospital for examination if symptoms of back pain, leg pain, and sacroiliac joint pain occur. Don't be lucky to delay your illness.

Early and correct diagnosis

The two major gold standards for the diagnosis of ankylosing spondylitis are: HLA-B27 positive and the sacroiliac joint disease. Early diagnosis and early treatment complement each other. After timely detection, it is necessary to go to the hospital for diagnosis, film inspection, and laboratory inspection to avoid delaying the illness.

Early and correct treatment

Once diagnosed as ankylosing spondylitis, it is necessary to treat in time, not to give up on yourself, and not to perform treatment. This is very unfavorable for the control of the condition, not only delaying the best time for the patient to treat, but also covering the patient's future life shadow.

Early adherence to treatment

Many patients with ankylosing spondylitis believe that early disease, as long as it is controlled by treatment, stops treatment after it no longer hurts. This view is wrong. Patients with early tonicity must insist on treatment, and they must have enough medicine, sufficient treatment course, adhere to treatment, and exercise.