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Morbus Bechterew is a chronic inflammatory rheumatische illness with priority of the backbone. The Latin concept "Morbus" means illness. In this case the illness is named after the Russian neurologist Vladimir Bechterew (1857-1927) to whom the illness did not describe though as a first, but about 1890 a Charakteristik much-noticed in the German-speaking space had published. n of the medical technical language is called the illness "Spondylitis ankylosans" (hardening whirl inflammation) or "ankylosierende Spondylitis" (in English "ankylosing spondylitis", shortened "ACE"). With the Morbus Bechterew the rheumatische inflammation concerns predominantly the backbone and the sacrum-intestinal leg joint. If the illness remains untreated, the ossifying rebuilding processes can lead to a complete stiffening of the backbone and the washbasin. Beside the backbone limb joints as well as internal organs can be also concerned by the inflammatory changes. Frequency Approximate 1% of the Central European population falls ill with a Morbus Bechterew, indeed, the illness is not recognised with all affected persons. After the up to now valid doctrine men are concerned about three times more often than women. Nevertheless, according to a survey of the "German union Morbus Bechterew" women fall ill nearly equally often, indeed, hardened with women the backbone as a rule more slowly than with men. The diagnosis position is often difficult As a rule pass up to the sure diagnosis position of a Spondylitis ankylosans on an average six years. This is due to the fact that the discomfort is often still untypical in the early stage and an inflammation of the sacrum-intestinal leg joint becomes possible in the X-ray picture only after longer course. The typical symptoms (deep-seated backache and Steifigkeit more than 3 months, movement restrictions LWS, decreased breath width) lead together with the röntgenologischen proof of the arthritis to the diagnosis.

Possibilities of treatment with the Morbus Bechterew With patients with Morbus Bechterew a certain genetic marker, so-called HLA-B27 is found to 95%. Indeed, this sign is not proving for a diagnosis because only 2-5% of the HLA-B27-positive population fall ill in ankylosierenden Spondylitis. Lab investigations play for the recognition of the illness rather a minor part. A raised blood sedimentation speed (BSG) and a raised C-reactive protein (CRP) are found only with 50-70% of the affected patients. The so-called rheumatic factor (RF) in the blood is not provable with Morbus Bechterew in general, which is why the clinical picture also belongs to seronegativen Spondylarthropathien (seronegativ = no proof of rheumatic factor in the serum). The course of the illness is very different. There are light courses with differently last among phases poor in complaint without essential functional interferences. With 80% of the Bechterew patients the working ability for decades is preserved away. Also after long courses the illness can come to the shutdown. Only with very much few patients (5%) develops the illness course so difficultly that in spite of optimum treatment a complete stiffening of the backbone is not already to be prevented after 10 years.

A healing of the Spondylitis ankylosans is not possible currently. Therefore, an optimum treatment is designed to relieve pains, to restrain the arthritis, to receive the movement ability as well as the working ability and to protect the quality of life of the affected person. Beside the medikamentösen therapy come up to the physiotherapy as well as accompanying cold uses and warm uses a determining value. To the pain relief and inflammation inhibition are used preferentially non-steroid ale Antirheumatika (NSAR). Glukokortikoide (cortisone-containing drugs) come with M. Bechterew only in special cases to the use: as a so-called push therapy in phases of high illness activity with strong discomfort (then the drug is taken or squirted) as well as to the specific treatment by joint or tendons beginning and mucus bag inflammations (then a syringe is given directly in the affected region). If spinal-distant joints are also concerned by the illness, the long-effective Antirheumatikum Sulfasalazin can be used. Differently than with the treatment of the spinal discomfort there is with this form of the joint participation a positive effect proof of this drug. The patients who have fallen ill for at least half a year and have not brought with their at least two NSAR the desired success can be treated with a drug from the group of the TNF alpha tailors. These so-called Biologics restrain in a way felt to processes belonging to body the cell messenger's material TNF alpha (tumour necrosis factor alpha) which plays a determining role in the inflammation process. Their good effectiveness is enough booked, in the meantime, indeed, here restrictions are also to be followed in the uses (e.g., with infections). Author: Jumper medicine State: 24/04/2009