Talk:Ankylosing spondylitis

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[edit] A

A well-known (in the UK) sufferer from AS is the former England cricket captain Mike Atherton. Loganberry 13:15, 12 Nov 2004 (UTC)

[edit] Gender differences

I've been reading up on this and the consensus among rheumatologists seems pretty clear that women and men are not affected equally. Comparison of x-rays found that men had greater spinal damage than women ref. Also the symptoms were different: men had more spinal involvement, women had more peripheral involvement. Women and men showed a similar level of disability which is surprising given that the level of spinal damage was not the same. This will of course lead people to think that the women are winging more, however x-rays are very poor at determining the level of inflammation. It may be that women who have the disease are experiencing just as much or even more inflammation and yet not experiencing the same level of spinal damage.

This study ref says nothing about whether men and women have the same likelihood of having A.S.

Related articles:

mr.z [05:55, 24 June 2007 (UTC)

[edit] Another Famous Ankyloser

I've read a number of places that Ed Sullivan (Famous American TV Talk Show Host 1901-1974) suffered from the disease - his posture and the way he held his neck would support that.

Was he famous for having AS? Otherwise it may not be a worthwhile addition. Was he as famous for having AS as Michael J Fox is for having Parkinson's? JFW | T@lk 22:13, 29 September 2005 (UTC)

I can appreciate putting Norman Cousins in the list of sufferers since he wrote a famous book with his illness as the focus. However, I wonder if he wasn't misdiagnosed. He became "cured," though there is no known cure for AS. His spine never "ankylosed." All in all, a top of the head diagnosis which doesn't stand up too well under the scrutiny of time. Student7 22:45, 11 January 2007 (UTC)

[edit] Removed Content

I have been reviewing the history of this page and I am at a loss trying to understand why some quite informative hyperlinks have been removed? I see numerous modifications saying "Reverted edits by xyz" without giving a REASON for removing what for all the world look like good contributions. So far I have only one "reverted edit" that I could see had a clear reason..

I found some useful links in the page history and I can't fathom the reason why they were removed, for example:

[edit] Alternative therapy

According to my consultant exercise is not an alternative therapy. Exercise is essential with Ankylosing Spondylitis. ALL experts recommend exercise combined with NSAIDs or anti-TNF medications. If you don't exercise the spinal fusion will be far worse - period. Putting exercise under the Alternative Therapy heading is misleading and potentially dangerous because it is not an alternative. The current article (21/12/2005, 12:35BST) suggests that exercise is an Alternative Therapy. That undermines the entire entry because it is such a basic thing to get wrong, and is even contradicted by the information referenced by the links.

...response from yb... Not everyone will define 'alternative therapy' the same way. Right or wrong some will consider almost anything that isn't drug therapy as alternative therapy.

Your point seems well supported in reputable sources, so I have added some outline levels in the article to clarify the issue. Don't be afraid to Wikipedia:Be bold in updating pages in the future, though. --Arcadian 01:34, 11 January 2006 (UTC)

[edit] Exclude impact exercise

Any sport that involves impact will have (especially in an active phase of the disease) almost immediate effects. I'm writing this as "jogging" is mentioned, and it can have a very high impact on all the AS affected joints, it probably shouldn't be recommended?

You can remove it, as long as you provide an adequate reference that a) impact exercise is not recommended and b) jogging counts as an impact exercise. I found a lot of articles about exercise but couldn't get to most full-text versions. Nothing mentioned impact sports or jogging in the abstracts. A search of the web found a lot of replication of this article and one other. I did find several sites which recommended jogging as long as it is not painful. I do not personally know of any proscription against jogging (and I've been seeing a lot of kids with spondyloarthritis recently!), so I wouldn't remove it myself! InvictaHOG 12:52, 11 August 2006 (UTC)
Just my two cents. I suffer from AS. My doctor also told me to not engage in any impact exercises if possible (I play basketball). She would allow jogging if it doesn't hurt but prefers I wouldn't. I tried light jogging and it didn't hurt while I was doing it. But the next morning I couldn't get up at all... ugh! Of course the disease has progressed untreated for a number of years already. I tried Pilates and I think it's better than swimming because it also strengthened my core muscles and was able to do more activities despite the pain.

Responsiblebum 07:54, 15 December 2006 (UTC)

There is the advice in the article that 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. Yes, jogging isn't great I know in first person, swimming is perfect since it envolves movements in a low-gravity environment. But AS is very complicated, all movements may improve or harm depending on how much of your spine is sealed, on how much your ankles are affected, and so on. In my opinion, an advice is sufficient. Sensei 09:47, 15 December 2006 (UTC)
I realize that this is merely "anectodal," but to confirm the above, I have been through quite a few tests recently in order to discover that my severe headaches were caused by herniated neck discs, most likely caused by jogging. I am 70 and had AS diagnosed some 20 years ago. I now use the cross-trainer and elevated treadmill to attain aerobic heartrates. On the plus side, my therapist pointed out that a usual surgical cure for herniation was fusion which I am getting "for free" from the AS! :) Student7 22:17, 11 January 2007 (UTC)
Add me to the anecdotal "rheumy said no jogging" chorus. Especially in my case, where my AS started in my hips/lower spine, jogging is #1 on the "Do not do under penalty of excruciating pain" list. Scarletsmith (talk) 12:59, 18 May 2008 (UTC)

[edit] Epidemiology

The Polish wiki states the ratio men:women is 10:1. Martin Kuštek 17:59, 14 October 2006 (UTC)

My rheumatologist says that the high men:women ratio in some sources is due to the fact that AS is often misdiagnosed in women because their symptoms are atypical of the "traditional" AS profile: Lots of lower back pain, sciatic symptoms that don't go away with treatment, etc., instead of stooped shoulders/neck/upper back. One study from 1998 indicated that about 20% of women diagnosed with AS developed it in their hips/pelvis area first and their symptoms coincided with a recent pregnancy (which puts a lot of strain on the lower spine as well as the immune system). My AS was diagnosed from my lower back pain (and confirmed on x-ray) after a number of orthopedists, neurologists, and other specialists missed what according to my rheumatologist should have been obvious symptoms (bone spurs up and down the spine, pain on changing positions from lying flat to standing or stooping to standing, etc.). Food for thought... Scarletsmith (talk) 12:56, 18 May 2008 (UTC)

[edit] Pope John Paul II

Please can anyone verify the reliability of such an article?
(John Reveille, M.D - UT-Huston)

[...] Like Pope John Paul II, many AS patients develop a curvature of the spine that forces them into a stooped position, with their head hanging lower than their shoulders. [...]

Sensei 07:40, 12 January 2007 (UTC)

Not a verification. I wonder if the writer of the quote was just taking a very visible stooping example that nearly everyone is familiar with and explaining that's what can happen to an AS sufferer. I don't believe the pope had AS. One article said osteoporosis, which sounds reasonable. Student7 12:39, 12 January 2007 (UTC)

[edit] Picture?

Could we not get a better picture for this article than the Leonard Trask "freakshow" poster?? I realize he's a historic case, but that image should be lower in the article. IMHO, it doesn't represent the article very well at all. ++ Arx Fortis 23:15, 24 January 2007 (UTC)

I asked to the Spondylitis American Association their permission to put one or two pictures in the article, especially the process of ankylosing, but I had no answer so far. --Sensei 06:22, 25 January 2007 (UTC)
Permission agreed from the Spondylitis Association of America. The site has been updated. -- Sensei 10:47, 27 January 2007 (UTC)

[edit] AS and Porphyria

The modifications adding porphyria were indented in order to distingush them from the text. I didn't find any evidence on PubMed about connections between autoimmune diseases and porphyria. I only found a case study, PMID 17048215 (patient with AS and porphyria), but I don't see any journal about this very particular topic.

If the modifier won't add a correct respected journal reference, I think it would be better to remove the modification. Sensei 15:03, 9 February 2007 (UTC)

We've had a prolific "porphyria expert" adding similar content to other articles. JFW | T@lk 16:53, 20 April 2007 (UTC)

[edit] Lancet

doi:10.1016/S0140-6736(07)60635-7 - recent review in the Lancet. JFW | T@lk 16:53, 20 April 2007 (UTC)

[edit] External links

External links to patient support groups (especially online chat boards), blogs, and fundraising groups normally not accepted on Wikipedia. Also, to prevent a proliferation of links, it's good to avoid more than one link to any website. Please read the external links policy and the specific rules for medical articles before adding more external links. WhatamIdoing (talk) 00:41, 13 January 2008 (UTC)