Rapid Review: Ankylosing Spondylitis

Ankylosing Spondylitis

• Patient will be a male
• Complaining of low back pain that’s worse in the morning and improves with exercise
• X-ray will show multiple vertebral fusions (bamboo spine)
• Labs will show increased ESR
• Most commonly caused by presence of HLA-B27
• Treatment is NSAIDs, physical therapy
• Comments: diseases associated with HLA-B27
  • PAIR: Psoriatic arthritis, Ankylosing spondylitis, Inflammatory bowel disease, Reactive arthritis

Sample question: A 51-year-old man presents with low back pain that has been worsening over the past several years. Radiographs of the spine demonstrate fusion of the sacroiliac joints and a “bamboo spine.” Blood tests reveal that he is human leukocyte antigen B27 positive. Which of the following findings on physical exam would be most consistent with the suspected diagnosis?