Another of the seronegative spondyloarthropathies—ankylosing spondylitis—demonstrates an arthritic predilection for the spine and pelvis. Ankylosing spondylitis is similar to rheumatoid arthritis in its association with morning stiffness and multisystem involvement with constitutional symptoms such as malaise, weakness, and fatigue. However, ankylosing spondylitis is clearly differentiated in its association with hereditary factors, particularly the HLA-B27 antigen and negative rheumatoid factor.
Ankylosing spondylitis is suspected in individuals younger than age 40 who note insidious onset of symptoms that improve with exercise, are associated with morning stiffness, and last longer than 3 months.16 Radiographic findings, in addition to genetic predisposition, are helpful in the diagnosis of ankylosing spondylitis. Squaring of the vertebral bodies (bamboo spine) and sacroiliitis are some of the more classic findings. Treatment consists of pain control with short-term and long-term management with NSAIDs.
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