BMJ Best Practice Podcast

Ankylosing spondylitis

Jun 20, 2022
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INSIGHT

Nature of Ankylosing Spondylitis

  • Ankylosing spondylitis is a chronic inflammatory disease mainly affecting the lower back and can spread to other areas.
  • It also causes extra-spinal symptoms like arthritis and enthesitis, with long-lasting stiffness and back pain worsening in the morning.
ADVICE

Diagnostic Approach

  • Start diagnosis with careful patient history and physical examination focused on inflammatory lower back symptoms.
  • Use laboratory tests including CRP, ESR, hemoglobin, and kidney function to evaluate systemic inflammation and drug safety.
ADVICE

Use MRI for Early Diagnosis

  • Use MRI of sacroiliac joints to confirm early diagnosis by detecting inflammation before structural damage occurs.
  • Plain radiographs may not detect early inflammation; MRI is preferred for suspected axial spondyloarthritis.
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