Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group What's wrong with me?

Kitty - Sounds like AS. Have all of those problems: thumbs, balls of feet (especially right foot), toes and hee3l of right foot with planta faciitis.

Have the rib cage involvement, enthesitis, see post to Janet. Also, L4/L5 posterior disc bulges, with facet joint arhtropathy in the lower lumbar spine. In additon (just for good measure) contochrondritis. Great fun - just keep stretching and make notes for your rheumy. don't take 'No' for an answer, and no, you aint a whiner. Far from it. You are in pain, one wants and needs a diagnosis, to which you are entitled.

Don't givve up. Keep on Keeping on.

Molly
Keeping on Keeping on (fighting to the last)

Hi Kitty, and welcome to kickas
Sounds very familiar to many of us, but your Rheumy will be able to tell you for sure. Could be AS, could be several other forms of autoimmune/ arthritis. I hope you will stay with us and let us know how your appointment goes on Tuesday. You and I are very close in age, I just turned 51.
Cindy

Thanks, Molly. I did look up some of this information. Not sure if that's what it is, since there was no mention of the rib area, but it might be. I printed it out for my therapist to see what she thinks. She's only a massage therapist, but is very knowledgeable, and does a great job in researching things that she can do to help different situations. She loves reading about medical things like this. Anyway, can't hurt.

At healthatoz.com it specifically talks about this in relation to AS.

I do use a heating pad on the area, and also cold packs, especially at night to help me sleep. They work for about an hour, then it wakes me up again.

Kitty - this is a good overview of AS: http://www.emedicine.com/med/topic2700.htm#target4 and yes, it does mention entheses. There are various links that you can follow up as well. But as Cindy points out, might not be AS at all (Hi cindy, hope you are doing good.) Keep us upto speed, OK?

Good luck with your appt tomorrow - and yes, *Welcome* to KA. Great group of wonderfully supportive and knowledgible people.

Molly
Keeping on Keeping on

Kitty (and Janet), here's some more for you - just a small selection from over 5000 possible 'hits':

http://en.wikipedia.org/wiki/Enthesitis

Enthesitis is an inflammation of the entheses, the location where a bone has an insertion to a tendon or a ligament. It is also called enthesopathy, or any pathologic condition involving the entheses. The entheses are any point of attachment of skeletal muscles to bone, where recurring stress or inflammatory autoimmune disease can cause inflammation or occasionally fibrosis and calcification. One of the primary entheses involved in inflammatory autoimmune disease is at the heel. Heel swelling and inflammation are therefore used to help diagnose certain inflammatory autoimmune diseases, including ankylosing spondylitis.

http://www.patient.co.uk/showdoc/40024909/

Ankylosing spondylitis is a chronic seronegative spondyloarthropathy which primarily involves the axial skeleton (e.g. sacroiliitis and spondylitis). The aetiology is unknown but involves the interaction of genetic and environmental factors. The diagnosis is made by combining clinical criteria of inflammatory back pain and enthesitis (inflammation at the site of bone insertion of ligaments and tendons) or arthritis with radiological findings.1

Symptoms may be subtle in early stages or mild disease.

Usually presents before the age of 30 years.
Most patients have mild chronic disease or intermittent flares with periods of remission.
Systemic features are common. Fever and weight loss may occur during periods of active disease.
Morning stiffness is characteristic, and fatigue is common.
Inflammatory back pain: insidious onset occurring over months or years. Often improves with moderate physical activity, and associated with diffuse non-specific radiation of pain into both buttocks. Unlike mechanical back pain, patients often experience stiffness and pain that awakens them in the early morning hours. The spinal disease starts in the sacroiliac joints (bilateral lumbosacral region) and progresses proximally, with ossification of the annulus fibrosus that results in fusion of the spine (bamboo spine). On examination there is often tenderness of the sacroiliac joints or a limited range of spine motion. May have loss of lumbar lordosis and accentuated thoracic kyphosis. Stiffness and kyphosis resulting in a stooped posture are characteristic in the advanced stages. (more)

http://cancerweb.ncl.ac.uk/cgi-bin/omd?enthesitis

enthesitis
Traumatic disease occurring at the insertion of muscles where recurring concentration of muscle stress provokes inflammation with a strong tendency toward fibrosis and calcification.

Origin: G. Enthetos, implanted, + -itis, inflammation (05 Mar 2000)

http://tinyurl.com/3doyo8

AS Guidebook

http://www.patient.co.uk/leaflets/enthesitis.htm - 41 resosurces for Enthesitis

http://www.diseases-condition.com/diseases-e/enthesitis.htm

Enthesitis Treatment
In recent years, the importance of enthesitis as the unifying basis for musculoskeletal disease in ankylosing spondylitis (AS) and the related spondyloarthropathies has been recognized. NSAIDs can relieve the inflammation and pain of reactive arthritis. Some, such as ibuprofen (Advil, Motrin, others) and aspirin, are available without a prescription. The most exciting development in the therapy of enthesitis-associated diseases is anti-tumor necrosis factor inhibitors, which seem to be able to suppress enthesitis completely in a significant number of cases. The optimal use of these agents for enthesitis associated diseases remains to be defined...(more)

----------------------------

My diagnosis was by MRI STIR images. Neither plain radiographics nor straightforward MRI showed the enthesitis. Might be worth mentioning that to your rheumy when you see em. (Note: Find it VERY difficult to lie flat on the floor, too painful (am like to a beached whale 'smile') and at night, lying flat in bed is also v. diff. so, I use pillows to support and to 'nestle' the back - pillows + my hottie = relief )

Molly
digging a bit - and now going out to dig in actuality (spring bulbs do call)

Molly,


good one, should be a sticky....!

Dave

Kitty,

you need to keep on top of the rib pain, if it's the costo' itis it can get nasty and it tends to spread quickly.

As Molly said it can be other things and as you have had gall bladder problems just keep an eye on it.....

Funny if I'm having an all over flare the gastro's and ER Dr.s always ask me about the front of the lower ribs, and up the back just above the diaphragm. But as the are always sore it does not seem so important or particularily useful.

Dave

Thanks Dave - It was worrying me that I hadn't addressed the thread properly - kept me awake last night! So spent some time in diggin a bit...

Molly
Now for the spade and fork and all those bulbs...

This article is particularly good, I think. It's written by and for medical professionals and is recently updated:
http://www.emedicine.com/med/topic2700.htm

Karen

Kitty,
It's hard when nobody can explain your pain and you begin to feel like you are just a whiner or a complainer. Once, before I was diagnosed, I blurted out to a doctor, "I'm not making this stuff up!"

But you are NOT whining. You are in pain and you are REPORTING your pain to a medical professional because that person needs to know where and how you hurt so that he can understand and treat that pain.

Keep reporting your pain until you get the help you need.

Karen