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doi:10.1093/humrep/dez170

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Introduction Clinical definition chronic inflammatory disorder that primarily affects the sacroiliac joint and spine Epidemiology Demographics more common in men peak onset age is 15-35 years of age Risk factors Etiology Unknown but may involve both genetic (e.g., HLA B-27 positivity) and environmental factors Pathogenesis unclear but involves inflammation, bone erosion, and spur formation involves the entheses Associated conditions psoriasis inflammatory bowel disease anterior uveitis aortic regurgitation Presentation Symptoms back pain stiffness of the spine with anterior uveitis Physical exam may have stooped posture positive Schober test decreased chest wall expansion Imaging indication findings CT will show bony changes but not active inflammation CT is most sensitive test to diagnose cervical fractures in patients with AS will detect inflammation, making it the best modality for early detection of AS in young patients obtain with cervical fractures to look for epidural hemorrhage Studies Labs HLA-B27 positivity Differential Mechanical low back pain Enteropathic arthritis Reactive arthritis Psoriatic arthritis Treatment Conservative patient education and exercise Medical nonsteroidal antiinflammatory drugs (NSAIDs) tumor necrosis factor (TNF) inhibitors Complications Low bone density due to inflammation and osteoporosis/osteopenia can predispose the patient to vertebral fractures Spine fracture leading to injury of the spinal cord Prognosis May lead to chronic pain and stiffness Create a free account or log in to see the cards.