Ankylosing spondylitis

1. Ankylosing spondylitis
Inflammatory
back pain
• Insidious onset at age <40
• Symptoms >3 months
• Relieved with exercise but not rest
• Nocturnal pain
Examination
findings
• Arthritis (sacroiliitis)
• Reduced chest expansion & spinal mobility
• Enthesitis (tenderness at tendon insertion sites)
• Dactylitis (swelling of fingers & toes)
• Uveitis
Complications
• Osteoporosis/vertebral fractures
• Aortic regurgitation
• Cauda equina syndrome
Laboratory
• Elevated ESR & CRP
• HLA-B27 association
Imaging
• X-ray of sacroiliac joints
• MRI of sacroiliac joints