Ankylosing Spondylitis: New Insights Into an old Disease – MM1702
Ankylosing spondylitis (AS) is a chronic systemic inflammatory disease characterised by sacroiliitis and
extra-articular manifestations. Consider the diagnosis of AS in young patients with back pain and stiffness early
in the morning and after prolonged sitting. Appropriate initial investigations are a plain x-ray of the pelvis and
blood tests for HLA-B27, erythrocyte sedimentation rate and C-reactive protein level. MRI can identify early
inflammatory bony changes not seen on x-ray and is prudent in patients with a clinical history consistent with
AS but a normal x-ray appearance. The mainstay of treatment for patients with AS remains NSAIDs and
stretching exercises. Tumour necrosis factor inhibitors are effective therapy for patients who fail to respond to firstline
treatments.
Modern Medicine – February 2017
