ANKYLOSING SPONDYLITIS

Question 1

Which antigen is it associated with?

Answer 1

HLA-B27

Question 2

epidemiology

Answer 2

men

aged 20-30 years

Question 3

features

Answer 3

man lower back pain and stiffness

stiffness worse in morning

improves with exercise

patient experiences pain at night which improves on getting up

Question 4

onset

Answer 4

insidious

Question 5

clinical exam features

Answer 5

reduced lateral flexion

reduced forward flexion - Schober’s test - a line is drawn 10 cm above and 5 cm below the back dimples (dimples of Venus). The distance between the two lines should increase by more than 5 cm when the patient bends as far forward as possible

reduced chest expansion

Question 6

other features - the A’s

Answer 6

Apical fibrosis

Anterior uveitis

Aortic regurgitation

Achilles tendonitis

AV node block

Amyloidosis

cauda equina syndrome

peripheral arthritis (25%, more common if female)