Website of the week

Sites on ankylosing spondylitis

This is a site aimed primarily at patients with ankylosing spondylitis (AS), but it still makes website of the week. The reason is the quality of the content of this UK charity’s free booklet. It can be accessed as a free PDF file, in contrast to some sites that charge for patient booklets.

The booklets are also available in hard-copy, post free, from the organisation. The 12 pages are colourful, well laid out and, apart from the usual questions and answers about AS that you would expect, contain an illustrated section on useful exercises that sufferers should endeavour to do every day.

The point is made that patients should not just rely on NSAIDs, but can take other action to help them to lead as normal a life as possible. Just click on the Guide Book link on the home page.

Having praised this initiative, I do have one criticism of the NASS website — there is really nothing for medical professionals — and there should be.

Why go there: Excellent advice for sufferers.

Downside: Nothing for doctors.

Information from: National Ankylosing Spondylitis Society.

Address: www.nass.co.uk

Related conditions

Seronegative arthritis involves other conditions such as anterior uveitis, Reiter’s disease, psoriatic arthritis, enteropathic synovitis and inflammatory bowel diseases.

This three-page PDF discusses all the seronegative mono-, oligo- and polyarthritides and their key features, but it is the flow chart on the second page that makes this article worth reading. This will help the GP to avoid missing an important HLA-B27-related condition.

Why go there: A useful aid to differential diagnosis.

Downside: None.

Information from: Journal of the Indian Academy of Clinical Medicine.

Address: http://medind.nic.in/jac/t03/i3/jact03i3p190.pdf

Aetiology

Although the clinical features and diagnosis of the seronegative spondyloarthritides are discussed here, the main focus is on understanding aetiology, including the relationship with the HLA-B27 gene and its role in the disease.

There is some speculation about the place of infection.

Like me, you may not have realised that until the advent of HIV infection in the 1980s, spondyloarthropathy was considered rare in Africa, a continent associated with HIV infection. It has now dramatically increased there and most patients diagnosed with spondyloarthropathies are HIV positive.

In psoriatic arthritis it is 92 per cent, in acute reactive arthritis is 87 per cent and in undifferentiated spondylo-arthropathy, 98 per cent. Why is this? You’ll have to read the article to find out.

Why go there: To extend your knowledge.

Downside: Takes a little time.

Information from: Arthritis Research Campaign

Address: www.arc.org.uk/about_arth/med_reports/series4/tr/6604/6604.htm

A quick brush-up

The antidote to the detailed information offered by the Arthritis Research Campaign website is this brief summary of AS from General Practice Notebook.

I’m not sure why people describe this condition and its associated elements in so many ways, but here the heading reads ‘spondylitis ankylopoetica’. But shouldn’t that be ‘ankylopoietica’? There are only a few paragraphs, but there are links to take you to more detail.

There is one black mark for this website, however. In order to survive this site carries advertising, some of whom come into the ‘snake oil merchant’ category, claiming amazing cures. I thought this site was for GPs so I can’t imagine that the uptake of these products is very high.

Why go there: A reminder of key facts.

Downside: Advertisements.

Information from: General Practice Notebook.

Address: www.gpnotebook.co.uk/simplepage.cfm?ID=-898957249

Patient Information

For those who want some basic advice, this website takes you to the printer-friendly version of an excellent patient fact sheet.

This version presents a clean-looking page with some helpful line drawings. The main points are briefly, but adequately covered in a sensible and non-threatening manner.

Why go there: You can confidently recommend it.

Downside: None.

Information from: BUPA.

Address: http://hcd2.bupa.co.uk/fact_sheets/html/ankylosing_Spondylitis.html?print

Dr Barnard is a former GP in Fareham, Hampshire

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