Ankylosing spondylitis: a contemporary perspective on diagnosis and treatment.
OBJECTIVE
In recent years, great progress has been made in the development of diagnostic tools, therapeutic approaches, and validated outcome measures in the understanding of the pathogenesis of ankylosing spondylitis (AS). The purpose of this review was to summarize these developments.


METHODS
We performed a PubMed search for the period 1978 to 2005, using the keyword, "ankylosing spondylitis," resulting in a total of 4878 publications, including 778 reviews. Articles were then selected based on their discussion of recent diagnostic tools and new treatment approaches in the pathogenesis of AS, leading to a final total of 104 articles.


RESULTS
In recent years, there have been 2 major developments in the management of AS that make earlier diagnosis possible and offer the hope of alleviating pain and preventing structural changes that result in loss of function. These developments include the use of magnetic resonance imaging to visualize the inflammatory changes in the sacroiliac joint and the axial spine, and the demonstration that tumor necrosis factor blocking agents are highly efficacious in reducing spinal inflammation and possibly in slowing radiographic progression.


CONCLUSIONS
There have been major advances in both the diagnostic tools and the therapeutic regimens available for patients with AS.
Mansour
Mark
M
Division of Rheumatology, Allergy, and Clinical Immunology, University of California, Davis, CA 95616, USA.
Cheema
Gurtej S
GS
Naguwa
Stanley M
SM
Greenspan
Adam
A
Borchers
Andrea T
AT
Keen
Carl L
CL
Gershwin
M Eric
ME
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D005260:Female; D015796:HLA-B27 Antigen / Q000235:genetics* / Q000276:immunology; D006801:Humans; D007249:Inflammation / Q000188:drug therapy*; D017116:Low Back Pain / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D010147:Pain Measurement; D013167:Spondylitis, Ankylosing / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
D000894:Anti-Inflammatory Agents, Non-Steroidal; D015796:HLA-B27 Antigen; D014409:Tumor Necrosis Factor-alpha