- 1:2000, male, 95% HLA-B27 +ve
- p/c: morning back pain/stiffness, progressive spinal fusion (ankylosis) = reduced spinal movement, kyphosis, SI joint fusion, neck hyperextension, and neck rotation, reduced chest expansion, hip/knee arthritis, enthesopathies, iritis, Crohn’s/UC (=IBD), heart disease, OP, psoriaform rashes.
- Ix: FBC (anaemia), ESR high, RhF –ve. Xray: widened SIJ and marginal sclerosis, later SI fusion and ‘bamboo spine’.
- Mx: alleviate systemic symptoms / pain, slow/stop progression. Exercise, NSAIDs (diclofenac 50mg), refer to rheum.