*Ankylosing Spondylosis

Question 1

Age of Onset

Answer 1

Teens-30’s

Unusually after 40 y/o

Question 2

Male/Female/Race

Answer 2

Males: 2-7x more common

Caucasian and Native American

Question 3

Family History

Answer 3

Positive

Question 4

Onset and Progression

Answer 4

Insidious onset

Progression: Becomes more severe and constant

Question 5

Symptom locations

Answer 5

Typically starts in low back (SI joint)

buttock, hips, and knees in some

Question 6

Symptom descriptors

Answer 6

pain/stiffness present for more than 3 months

Pain and ache, at times sharper soreness

Question 7

Aggravating Factors

Answer 7

Rest and Inactivity

Post-rest gel: more than 30 minutes

Question 8

Alleviating factors

Answer 8

Movement

Question 9

24 hour report

Answer 9

Morning severe stiffness, often lasts longer than 1 hour

Question 10

Review of Systems

Answer 10

Fever

Fatigue

Anorexia

Weight loss

uveitis/iritis

pericarditis

amyloidosis

CAD

AAA

Question 11

ROM/Mobility

Answer 11

Loss of spine mobility in all directions

4th rib level loss of chest wall excursion <4cm

Question 12

Palpation/Observation

Answer 12

Kyphotic T-spine

Flat L-spine

Stooped posture

Question 13

Complications

Answer 13

Osteoporosis

Fractures (dens, C6-7)

C1-2 subluxation

Spinal Stenosis

Cario/pulmonary complications

Question 14

Lab Tests

Answer 14

Positive HLA-B27

Elevated ESR

Elevated C-reactive protein

Question 15

Diagnostic Imaging

Answer 15

Sacroilitis:

• blurred joint margins
• sclerosis
• joint space narrowing

Bamboo spine