Early diagnosis is preponderant to exacerbate associated comorbidities.
Doctor José Rodríguez Santiago, rheumatologist. Photo: Provided by the specialist to the Journal of Medicine and Public Health.
The Doctor Jose Rodriguez Santiago, rheumatologistexclusively reported to the Journal of Medicine and Public Health, that Ankylosing Spondylitis is a condition that is no longer related to the elderly.
“We are talking about young people between 20 and 30 years of age, although it is more identifiable in young men and the prevalence is 0.06 percent”, which affects men and women in similar proportions, although it was believed that it was mostly in men, as indicated by the specialist.
Rodríguez stressed that the clearest symptom is severe back pain, which although it can be confused with other conditions, “and that is the main reason why a patient can take up to 10 years to be diagnosed correctly. Because if you work in loading zones, or even sitting in front of a computer, mechanical-type back pain is going to come from the lifestyle.”
In this sense, he indicated that at the moment in which the symptoms are exacerbated and the curvature of the spine is increasing, the patient is exposed to cardiovascular and intestinal diseases and difficulty breathing. “Because we are going to have a decrease in the expansion of the lungs, and unfortunately when the patient has the possibility of recovery, since that patient could develop osteoporosis.”
The rheumatologist He emphasized that this condition carries a series of severe complications, “therefore, although it is not very frequent, it must be detected in time, “because when we talk about spondylopathy, sometimes one disease is mixed with another. We are talking about a series of comorbidities”.
Treatments to slow progress
“We can delay progress. It is very important because many patients come to the office asking if there is a cure, but no, there is no cure. There is no cure for any autoimmune inflammatory rheumatic disease. We prevent it from progressing,” she stated.
For this reason, he assured that the correct moment to achieve progression is detection 10 years in advance, on average, to avoid complications. Yes, we have recently approved inflammatory process modulators and biologicals that can be used.
“Genetics is very important, since the HLA-B27 gene, which predisposes the vast majority of Caucasians and here in Puerto Rico, having a very interesting mixture of races, we cannot say, based on how people look, whether or not a patient is predisposed. Sometimes we see people who have the gene, even though they don’t look like it.”
“We cannot say that lifestyles have an influence on spondylitis,” explained the specialist, who specified that the higher incidence level is determined by genes.
Diagnosis of Ankylosing Spondylitis
Patients who suspect this possible diagnosis should undergo magnetic resonance imaging with contrast, where the rheumatologist You will be able to see with certainty and verify the injury that an X-ray could not detect.
“In this study you can see the inflammatory changes, and for that reason you can be sure that there is no reason not to diagnose in time. The patient who suspects should be direct and honest with the primary physician, telling him that he has pain that does not improve with treatment, and thus the doctor should suspect that he is dealing with a young person who has the disease and should refer, “he said.
He emphasized that if there is a 60-year-old patient with the condition, “he must already have at least 30 years with the disease and there is not much to do in terms of preventing progress. But you can work on pain management, ”she concluded.
See the interview: