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