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Ankylosing Spondylitis

A systemic chronic autoimmune spondyloarthropathy characterized by -

  • HLA-B27 histocompatibility complex positive (90%)
  • RF negative (seronegative)
  • primarily affect the axial spine


Causes - there is a genetic predisposition, but mode of inheritance is unknown. HLA-B27 is located on the sixth chromosome, B locus.

Symptoms -

Lumbosacral pain and stiffness

  • present in most patients
  • worse in morning
  • insidious onset in 3rd decade of life


Neck and upper thoracic pain

  • occurs later in life
  • acute neck pain should raise suspicion for fracture


Sciatica- likely originates from sciatic nerve involvement in the pelvic (piriformis spasm)

loss of horizontal gaze.

shortness of breath - caused by costovertebral joint involvement, leading to reduced chest expansion.


Investigations - A thorough clinical examination by your clinician.

  •  MRI
  • Xray
  • Bone scan
  • CT scan
  • Blood tests


Treatment -

Nonoperative 

  • NSAIDS, COX-2 inhibitors, and therapy
  •  physical therapy should focus on maintaining flexibility

Operative