Ankylosing Spondylitis

Damon F. Lee, MD Reviewed 06/2017
 


BASICS

DESCRIPTION

  • Ankylosing spondylitis (AS) is an axial inflammatory spondyloarthropathy (axSpA) characterized by radiologic evidence of sacroiliitis.

  • System(s) affected: musculoskeletal; eyes; cardi...

DIAGNOSIS

HISTORY

  • Inflammatory back pain

    • ▪ Insidious onset
    • ▪ Duration >3 months
    • ▪ Morning stiffness in spine lasting >1 hour
    • ▪ Night time awakenings secondary to back pain
    • ▪ Pain and stiffness increas...

TREATMENT

GENERAL MEASURES

  • Aggressive physical therapy is the most important nonpharmacologic management.

  • Posture training and spinal range-of-motion exercises are essential.

  • Firm bed; sleep in supine po...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Symptom control and maintenance of mobility and function are primary treatment goals.

  • Monitor posture and range of motion with 6- to 12-month vis...

REFERENCES

Reveille  JD, Weisman  MH. The epidemiology of back pain, axial spondyloarthritis and HLA-B27 in the United States. Am J Med Sci.  2013;345(6):431–436. [View Abstract on OvidInsights]

ADDITIONAL READING

  • Baraliakos X, van den Berg R, Braun J, et al. Update of the literature review on treatment with biologics as a basis for the first update of the ASAS/EULAR management recommendation...

SEE ALSO

Arthritis, Psoriatic; Arthritis, Rheumatoid (RA); Crohn Disease; Reactive Arthritis (Reiter Syndrome); Ulcerative Colitis 

CODES

ICD10

  • M45.9 Ankylosing spondylitis of unspecified sites in spine

  • M08.1 Juvenile ankylosing spondylitis

  • M45.8 Ankylosing spondylitis sacral and sacrococcygeal region

  • M45.6Ankylosing spondylitis lumba...

CLINICAL PEARLS

  • Diagnosis of AS is suggested by a history of inflammatory back pain, evidence of limited chest wall expansion, restricted spinal movements in all planes, radiographic evidence of sacro...

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